Provider Demographics
NPI:1992184279
Name:HATLING, TAMMY (QMHP)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:HATLING
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 S U ST
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-3904
Mailing Address - Country:US
Mailing Address - Phone:541-521-8729
Mailing Address - Fax:
Practice Address - Street 1:932 S U ST
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424-3904
Practice Address - Country:US
Practice Address - Phone:541-521-8729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health