| Doctor Name: | EILEEN M. HATHAWAY |
| NPI Number: | 1003086059 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LLP |
| License Number: | 6301009001 |
| Business Practice Address: | 5030 Northwind Dr Suite 108 East Lansing, MI - 488235034 |
| Business Phone Number: | 5173364335 |
| Business Fax Number: | 5173360101 |
| Mailing Address: | Po Box 10, MASON |
| State: | MI |
| Postal Code: | 488540010 |
| Phone Number: | 5173364335 |
| Fax Number: | |
| NPI Enumeration Date: | 03/06/2008 |
| NPI Last Update Date: | 09/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 6301009001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |