Provider Demographics
NPI:1942346002
Name:HATFIELD, TAMMY D (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:D
Last Name:HATFIELD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9507 DELPHINIUM ST
Mailing Address - Street 2:#101
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-6548
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:410 MEIJER DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-5128
Practice Address - Country:US
Practice Address - Phone:859-980-7937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1407103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY69-0619421OtherHUMANA
KY68-0619421OtherCHA
KY000000386635OtherANTHEM BLUE CROSS BLUE SH