Individual
STEPHANIE HATHCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., BCBA
Contact information
Practice address
905 DOGWOOD DR, FAYETTEVILLE, TN 37334-2261
(423) 368-2933
Mailing address
905 DOGWOOD DR, FAYETTEVILLE, TN 37334-2261
(423) 368-2933
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-11-8458
TN
Other
Enumeration date
12/02/2013
Last updated
06/25/2020
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