NPI 1700564507

Amanda Hatathlie

Practitioner Other Technician Polacca, AZ

Practice location

Address: Highway 264 Mile Post 388, Polacca, AZ 86042
Phone: (928) 737-6000
Mailing address: PO Box 801, Polacca, AZ 86042-0801

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X Licence 2517199 (AZ)

Other Technician, Other providers in Arizona →

Registry record

NPI: 1700564507
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 Jul 2023
Record last updated: 11 Jul 2023

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.