Individual ProviderHeather L HathawayMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address45445 Portola Ave, Suite 2b, Palm Desert, CA 92260-4844(760) 977-8189PECOS EnrollmentBased on the most recent information from CMS, provider Heather L Hathaway does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1194999755Provider TypeIndividualFull NameHathaway, Heather LCredentialLMFT 51143GenderFemaleSole ProprietorYesEnumeration Date4/15/2008Last Updated2/25/2019Contact InformationPractice LocationPractice Address45445 Portola Ave, Suite 2b, Palm Desert, CA 92260-4844Phone(760) 977-8189Fax(760) 610-5366Mailing LocationMailing Address45445 Portola Ave Ste 2b, #7, Palm Desert, CA 92260-4844Phone(760) 977-8189Fax(760) 610-5366Provider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseMFC 51143CaliforniaCode106H00000XDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseIMF56344California