Individual
MR. MICHAEL R HATHCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
800 NE 19TH ST, MOORE, OK 73160-6302
(405) 912-5145
(405) 912-5147
Mailing address
18350 ROLLING OAK RD, NEWALLA, OK 74857-1255
(405) 618-1081
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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