Provider Demographics
NPI:1629037684
Name:BATEMAN, MARIE KATHLEEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:KATHLEEN
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 DEBARR RD
Mailing Address - Street 2:SOCIAL & BEHAVIORAL HEALTH SERVICE
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2983
Mailing Address - Country:US
Mailing Address - Phone:907-257-4850
Mailing Address - Fax:907-257-6747
Practice Address - Street 1:2925 DEBARR RD
Practice Address - Street 2:SOCIAL & BEHAVIORAL HEALTH SERVICE
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2983
Practice Address - Country:US
Practice Address - Phone:907-257-4850
Practice Address - Fax:907-257-6747
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2772042501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical