Provider Demographics
NPI:1104301936
Name:HATCH, ELIZABETH C (MAS, LMFT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:HATCH
Suffix:
Gender:F
Credentials:MAS, LMFT
Other - Prefix:
Other - First Name:LIZ
Other - Middle Name:
Other - Last Name:HATCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2200 E WILLIAMS FIELD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-0764
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 E WILLIAMS FIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-0764
Practice Address - Country:US
Practice Address - Phone:480-442-3781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-15503106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist