Individual
MARIAH KAY HATKEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3016 PORTAGE AVE, SOUTH BEND, IN 46628-3501
(574) 272-9100
Mailing address
1318 N LAFAYETTE BLVD, SOUTH BEND, IN 46617-1139
(574) 229-1298
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31007242A
IN
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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