| NPI | 1518001668 |
|---|---|
| Former Name | CAROL JEAN HATHAWAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP30006082) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2023-08-01 |