| NPI | 1013290568 |
|---|---|
| Former Name | HEATHER ANNE HATHAWAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KS 5010) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MD 22096) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2019-11-19 |