IndividualActive
Amanda Hatathlie
NPI 1700564507 · Other Technician · Polacca, AZ
Provider details
- NPI number
- 1700564507
- Entity type
- Individual
- Primary specialty
- Other TechnicianTechnologists, Technicians & Other Technical Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 2517199 (AZ)
Mailing address
Po Box 801
Polacca, AZ 86042-0801
Registry dates
- Enumerated
- 2023-07-11
- Last updated
- 2023-07-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.