Individual provider · Type 1 NPI

Ian McCloud Hathaway

Mental Health Counselor · Banning, CA

NPI number 1326360892 Active

Practice location

3705 W Ramsey St
Banning, CA 92220-3511

Call (760) 288-4579 Map

Fax (760) 288-3752

Mailing address

3705 W. Ramsey St.
Banning, CA 92220

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1326360892

Ian McCloud Hathaway's National Provider Identifier is 1326360892, issued on Feb 24, 2010. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Banning, CA. The record was last updated on Feb 24, 2010.