Provider Demographics
NPI:1023726304
Name:HATTEN, ANTHONY LAMAR JR
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:LAMAR
Last Name:HATTEN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2528 N SARTAIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-1408
Mailing Address - Country:US
Mailing Address - Phone:267-340-0906
Mailing Address - Fax:
Practice Address - Street 1:2528 N SARTAIN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-1408
Practice Address - Country:US
Practice Address - Phone:215-227-3528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor