Individual
SETH R. HATLELID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.006972
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05732028
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/21/2006
Last updated
06/11/2010
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