Provider Demographics
NPI:1083748271
Name:HATCH, PAULA J (OT)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:HATCH
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 WIESE LN
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53406
Mailing Address - Country:US
Mailing Address - Phone:262-886-2514
Mailing Address - Fax:
Practice Address - Street 1:8700 DURAND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:STURTEVANT
Practice Address - State:WI
Practice Address - Zip Code:53177
Practice Address - Country:US
Practice Address - Phone:262-886-2599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3329-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist