Individual
LADAWN HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006914
MEDICARE PTAN
KS
05
—
100098150A
—
KS
05
—
100098150B
—
KS
Enumeration date
11/03/2009
Last updated
11/09/2011
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