Provider Demographics
NPI:1326239179
Name:HATTON, MICHELLE CAROLINE (OTR/L)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CAROLINE
Last Name:HATTON
Suffix:
Gender:F
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:PO BOX 650
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32056-0650
Mailing Address - Country:US
Mailing Address - Phone:386-438-5427
Mailing Address - Fax:386-438-5449
Practice Address - Street 1:4852 S US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-0310
Practice Address - Country:US
Practice Address - Phone:386-438-5427
Practice Address - Fax:386-438-5449
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9470174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist