NPI 1356066948
Jennifer Hathorn, IDDWAIVERSERVICES
Practice location
- Address
- 1925 Ellisville Blvd, Laurel, MS 39440-5426
- Phone
- (601) 651-2923
- Mailing address
- PO Box 18679, Hattiesburg, MS 39404-8679
Registered specialties
Day Training/Habilitation Specialist
Primary
Registry record
- NPI
- 1356066948
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 6 Oct 2022
- Record last updated
- 6 Oct 2022
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.