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Individual

MICHELLE HATHAWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
415 RODMAN RD, AUBURN, ME 04210-3942
(207) 376-3022
Mailing address
800 CENTER ST, AUBURN, ME 04210-6404
(207) 782-2726
(207) 782-2726

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-7419
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-10-7419
BCBA
Enumeration date
12/01/2010
Last updated
12/01/2010
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