Provider Demographics
NPI:1700281912
Name:HATCHER, JOE WARREN
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:WARREN
Last Name:HATCHER
Suffix:
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 1:960 THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:WI
Mailing Address - Zip Code:54971-1804
Mailing Address - Country:US
Mailing Address - Phone:920-748-8334
Mailing Address - Fax:920-748-7243
Practice Address - Street 1:960 THOMAS ST
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:WI
Practice Address - Zip Code:54971-1804
Practice Address - Country:US
Practice Address - Phone:920-748-8334
Practice Address - Fax:920-748-7243
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2987-57103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling