Provider Demographics
NPI:1205121886
Name:HATCH, EMMA BIANCA (MSW, PCSW)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:BIANCA
Last Name:HATCH
Suffix:
Gender:F
Credentials:MSW, PCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1310
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-3036
Mailing Address - Country:US
Mailing Address - Phone:307-856-9281
Mailing Address - Fax:307-856-1630
Practice Address - Street 1:14 GREAT PLAINS ROAD
Practice Address - Street 2:
Practice Address - City:ARAPAHOE
Practice Address - State:WY
Practice Address - Zip Code:82510-3036
Practice Address - Country:US
Practice Address - Phone:307-856-9281
Practice Address - Fax:307-856-1630
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYCSW-1841041C0700X
WYLCSW-11881041C0700X
WYPCSW-7041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical