Provider Demographics
NPI:1841762697
Name:HATTEN, JATARIS DEANTHONY (MS)
Entity Type:Individual
Prefix:
First Name:JATARIS
Middle Name:DEANTHONY
Last Name:HATTEN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3603 MEADOWGLEN VLG LN APT J
Mailing Address - Street 2:
Mailing Address - City:DORAVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30340-5370
Mailing Address - Country:US
Mailing Address - Phone:601-580-2768
Mailing Address - Fax:
Practice Address - Street 1:3603 MEADOWGLEN VLG LN APT J
Practice Address - Street 2:
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30340-5370
Practice Address - Country:US
Practice Address - Phone:601-580-2768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health