Individual
MISS STEPHANIE DAWN HATHCOAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC US
Contact information
Practice address
1515 W CHICKASAW AVE, SALLISAW, OK 74955-7201
(918) 775-2657
(918) 775-0439
Mailing address
PO BOX 2, PARK HILL, OK 74451-0002
(918) 775-2657
(918) 775-0439
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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