Individual
ALEXANDRIA YVETTE HATHERILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN, RN
Contact information
Practice address
1664 BROADWAY, EL CAJON, CA 92021-5201
(619) 579-8685
Mailing address
1664 BROADWAY, EL CAJON, CA 92021-5201
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
11/16/2023
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