Individual
MARCIA J HARTWIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5620
(601) 268-5720
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5463
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
41-670
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126033
—
MS
01
—
640507572RU
AMERICAN ADMIN GROUP
MS
01
—
680015806
RAILROAD MEDICARE
—
Enumeration date
08/12/2006
Last updated
01/30/2015
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