Individual
MRS. SHANA MARIE HATCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1322 W MAIN ST, ANTLERS, OK 74523-2016
(580) 298-5062
(580) 298-9958
Mailing address
PO BOX 153, SOPER, OK 74759-0153
(580) 239-9155
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200111200A
—
OK
Enumeration date
10/30/2013
Last updated
10/30/2013
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