Provider Demographics
NPI:1093142333
Name:HATRIDGE, WILLIAM RAYMOND (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:RAYMOND
Last Name:HATRIDGE
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 HIGHWAY 234
Mailing Address - Street 2:
Mailing Address - City:ASHDOWN
Mailing Address - State:AR
Mailing Address - Zip Code:71822-9059
Mailing Address - Country:US
Mailing Address - Phone:903-278-4255
Mailing Address - Fax:
Practice Address - Street 1:582 HIGHWAY 365
Practice Address - Street 2:SUITE 3
Practice Address - City:MAYFLOWER
Practice Address - State:AR
Practice Address - Zip Code:72106-9524
Practice Address - Country:US
Practice Address - Phone:501-470-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2638225X00000X
TX115647225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist