Provider Demographics
NPI:1861278731
Name:HATCH, STEPHEN GABRIEL (PHD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GABRIEL
Last Name:HATCH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:S.
Other - Middle Name:GABE
Other - Last Name:HATCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:716 W 630 S
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-6022
Mailing Address - Country:US
Mailing Address - Phone:801-473-0808
Mailing Address - Fax:
Practice Address - Street 1:716 W 630 S
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6022
Practice Address - Country:US
Practice Address - Phone:801-473-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13559089-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical