Individual
TARA HATFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
504 E 24TH ST, TISHOMINGO, OK 73460-3214
(580) 371-9933
Mailing address
1406 SHEPHERD HILLS RD, SULPHUR, OK 73086-8563
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
100746580E
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000
—
OK
Enumeration date
02/15/2010
Last updated
02/15/2010
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