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Organization
CENTRAL CONSOLIDATED SCHOOL DISTRICT
Active
Organization
CENTRAL CONSOLIDATED SCHOOL DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HATHCOCK M.S. SLP-CF (SPEECH LANGUAGE PATHOLOGIST)
(505) 720-0198
Entity
Organization
Contact information
Practice address
HIGHWAY 64, OLD HIGH SCHOOL ROAD, SHIPROCK, NM 87420
(505) 368-4984
Mailing address
PO BOX 1199, SHIPROCK, NM 87420-1199
(505) 368-4984
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
NULL
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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