Provider Demographics
NPI:1528364189
Name:HATLEY, EUGENIA LEE (MSW)
Entity type:Individual
Prefix:MRS
First Name:EUGENIA
Middle Name:LEE
Last Name:HATLEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 LYCKAN PKWY STE B
Mailing Address - Street 2:SUITE 6008
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2541
Mailing Address - Country:US
Mailing Address - Phone:919-381-6816
Mailing Address - Fax:919-381-6818
Practice Address - Street 1:3700 LYCKAN PKWY SUITE B
Practice Address - Street 2:SUITE 6008
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2587
Practice Address - Country:US
Practice Address - Phone:919-381-6816
Practice Address - Fax:919-681-6818
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0054191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical