Individual
TINA M HYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 BOOTH ST, ELKTON, MD 21921-5657
(410) 996-5104
Mailing address
457 MOUNT OLIVET CHURCH RD, FAWN GROVE, PA 17321-9611
(443) 717-2539
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
G11102
MD
Other
Enumeration date
08/20/2011
Last updated
08/20/2011
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