Individual
MS. CALLIE ANN HATHCOAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
720 COLLEGE CT, TAHLEQUAH, OK 74464-4741
(918) 453-0841
Mailing address
720 COLLEGE CT, TAHLEQUAH, OK 74464-4741
(918) 453-0841
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30
OK
Other
Enumeration date
03/06/2008
Last updated
10/11/2013
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