Individual
KATHY HATTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
RR 3 BOX 897, FAIRFIELD, IL 62837-9027
(618) 895-4260
Mailing address
RR 3 BOX 897, FAIRFIELD, IL 62837-9027
(618) 895-4260
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
57002446
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8030288
BLUECROSS/BLUESHIELD IL
IL
Enumeration date
08/20/2006
Last updated
02/15/2010
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