Provider Demographics
NPI:1184811465
Name:HATTEN, LEIGH ANNE (LMFT MMT)
Entity type:Individual
Prefix:MS
First Name:LEIGH
Middle Name:ANNE
Last Name:HATTEN
Suffix:
Gender:F
Credentials:LMFT MMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:723 E COLLEGE ST
Mailing Address - Street 2:APT 1
Mailing Address - City:BOWDON
Mailing Address - State:GA
Mailing Address - Zip Code:30108
Mailing Address - Country:US
Mailing Address - Phone:770-258-5575
Mailing Address - Fax:
Practice Address - Street 1:723 E COLLEGE ST
Practice Address - Street 2:APT 1
Practice Address - City:BOWDON
Practice Address - State:GA
Practice Address - Zip Code:30108
Practice Address - Country:US
Practice Address - Phone:770-258-5575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMI001733225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist