Provider Demographics
NPI:1134355589
Name:HATTON, LAURA (MS, LLP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HATTON
Suffix:
Gender:F
Credentials:MS, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 PAULINE BLVD
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-5003
Mailing Address - Country:US
Mailing Address - Phone:734-994-9466
Mailing Address - Fax:734-994-9465
Practice Address - Street 1:1955 PAULINE BLVD
Practice Address - Street 2:SUITE 100A
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-5003
Practice Address - Country:US
Practice Address - Phone:734-994-9466
Practice Address - Fax:734-994-9465
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013865103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist