Doctor Name: | TERESA L HIATT |
NPI Number: | 1225289010 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BGS |
License Number: | |
Business Practice Address: | 118 N Sally Dr Winamac, IN - 469969100 |
Business Phone Number: | 5749464233 |
Business Fax Number: | 5749464365 |
Mailing Address: | 118 N Sally Dr, WINAMAC |
State: | IN |
Postal Code: | 469969100 |
Phone Number: | 5749464233 |
Fax Number: | 5749464365 |
NPI Enumeration Date: | 10/10/2008 |
NPI Last Update Date: | 10/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |