1598996001

Everything you always wanted to know about HOTHORN M PATRICIA LCSW but were afraid to ask.

HOTHORN M PATRICIA LCSW

You can also download the this 1598996001 data report as csv | excel | json | xml
Provider Last Name Provider Middle Name Provider First Name Provider Credential
HOTHORN M PATRICIA LCSW
Gender:
Female
Enumeration date:
2009-07-31
Last update date:
2012-11-27
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
1514698 Medicaid none TN

Taxonomies

Taxonomy State License Number Primary?
1041C0700X Clinical CA LCS 11605 N

Phone Numbers

Type Number
Mailing Address Telephone Number 6156615039
Practice Location Address Telephone Number 6156615039
Mailing Address Fax Number 6153769278
Practice Location Address Fax Number 6153769278

Addresses

Type Address City State Postal Country
Mailing Address 915 LAURENS WAY SUITE 120 BRENTWOOD TN 37027 TN
Practice Location Address 100 WINNERS CIR N BRENTWOOD TN 37027 TN

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1629245667 HINTON OSWALT, PATRICE
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1871845875 RECORD, JULIANN
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1912259904 HUGH, JAMES
Individual
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Other NPI Records that share an identifier

NPI Name Address State City Identifier types that matches
1497790992 MILLER, CYNTHIA
Individual
805 S CHURCH ST TN MURFREESBORO Identifier: 1514698 (Medicaid)