Provider Demographics
NPI:1114402534
Name:HOTARD, MARY EMILIE
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:EMILIE
Last Name:HOTARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2701
Mailing Address - Country:US
Mailing Address - Phone:985-290-2044
Mailing Address - Fax:
Practice Address - Street 1:1537 3RD ST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2701
Practice Address - Country:US
Practice Address - Phone:504-920-6782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor