1568698207 NPI number — MRS. RAECHEL CHRISTEENE HATAWAY MS, CF-SLP

Table of content: MRS. RAECHEL CHRISTEENE HATAWAY MS, CF-SLP (NPI 1568698207)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568698207 NPI number — MRS. RAECHEL CHRISTEENE HATAWAY MS, CF-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HATAWAY
Provider First Name:
RAECHEL
Provider Middle Name:
CHRISTEENE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, CF-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ERWIN
Provider Other First Name:
RAECHEL
Provider Other Middle Name:
CHRISTEENE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1568698207
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 WESTERN RIDGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GATESVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76528-9400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-223-2542
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
420 N 10TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEAGUE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75860-1218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-739-1350
Provider Business Practice Location Address Fax Number:
254-519-3477
Provider Enumeration Date:
06/09/2009

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:  105075 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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