Ethel W Hetrick Phd Pllc

LBN: Ethel W Hetrick Phd Pllc
Ethel W Hetrick Phd Pllc is an health care organization with primary practice located at 412 Highway 90 Suite 10, Bay St Louis MS 39520-3534. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as the primary health care specialty. Ethel W Hetrick Phd Pllc can be contacted via phone (228) 467-2424, or through Hetrick, Ethel W via phone (228) 467-2424.

Contact Information

Primary practice address
412 Highway 90 Suite 10 Bay St Louis MS 39520-3534
Phone: (228) 467-2424
Fax: (228) 467-5757
Website:
Map and Directions
Authorized official contact:
Name: Hetrick, Ethel W PHD
Phone: (228) 467-2424

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 45 740 Mississippi

Profile Details

NPI number 1215342514
LBN Legal business name Ethel W Hetrick Phd Pllc
DBA Doing business as
Authorized official Hetrick, Ethel W PHD
Entity Organization
Organization subpart 1 No
Enumeration date Jun 25th, 2014
Last updated Jun 25th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1215342514 NPPES
Mississippi MEDICAID 02628066

Popular Providers