Provider Demographics
NPI:1831498807
Name:HATCHER, LEA ANNE
Entity Type:Individual
Prefix:MRS
First Name:LEA ANNE
Middle Name:
Last Name:HATCHER
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 1:1111 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:FT. WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102
Mailing Address - Country:US
Mailing Address - Phone:817-348-0956
Mailing Address - Fax:817-948-0956
Practice Address - Street 1:1111 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-3425
Practice Address - Country:US
Practice Address - Phone:817-348-0956
Practice Address - Fax:817-948-0956
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107483225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist