Individual
SUSAN HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3783 WEST 800 SOUTH, PORTLAND, IN 47371
(260) 729-1153
Mailing address
P.O. BOX 24, PORTLAND, IN 47371
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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