Individual
MRS. MARYANNA JULIA HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,LPC,NCC
Contact information
Practice address
105 HALL ST, TRAVERSE CITY, MI 49684-2288
(231) 935-4234
(231) 995-7900
Mailing address
105 HALL ST, TRAVERSE CITY, MI 49684-2288
(231) 935-4234
(231) 995-7900
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704171470
MI
Other
Enumeration date
02/06/2013
Last updated
02/06/2013
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