Individual
MICHAEL HATHCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS CCC-SLP
Contact information
Practice address
PO BOX 1199, SHIPROCK, NM 87420-1199
(505) 368-4984
Mailing address
PO BOX 1199, SHIPROCK, NM 87420-1199
(505) 368-4984
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SAH-2024-0023
NM
Other
Enumeration date
09/16/2024
Last updated
09/16/2024
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