1255761672 NPI number — JANET SIAR HATCHER SLP

Table of content: JANET SIAR HATCHER SLP (NPI 1255761672)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255761672 NPI number — JANET SIAR HATCHER SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HATCHER
Provider First Name:
JANET
Provider Middle Name:
SIAR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255761672
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8823 PRODUCTION LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OOLTEWAH
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37363-6511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-238-7217
Provider Business Mailing Address Fax Number:
423-954-7408

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
311 CONGRESS PKWY N
Provider Second Line Business Practice Location Address:
STE 800
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37303-1699
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-744-0890
Provider Business Practice Location Address Fax Number:
423-744-0849
Provider Enumeration Date:
11/21/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  2560 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2560 . This is a "SLP LICENSE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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