Individual
MRS. ELISA SUNSHINE HATMAKER-LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
900 6TH AVE, SAINT ALBANS, WV 25177-2921
(304) 395-1850
Mailing address
PO BOX 8888, SOUTH CHARLESTON, WV 25303-0888
(304) 395-1850
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
996
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810022109
—
WV
Enumeration date
06/14/2010
Last updated
03/16/2012
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