Individual
MARLENA HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
102 COMPASS POINT DR, SAINT CHARLES, MO 63301-4404
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2018011004
MO
101YM0800X
Mental Health Counselor
2018011004
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490092511
—
MO
Enumeration date
07/28/2020
Last updated
12/19/2022
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