Hetrick, Ethel Wiest

Hetrick, Ethel Wiest is an sole proprietor health care provider with primary practice located at 412 Highway 90 Suite 10, Bay Saint Louis MS 39520-3534. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Hetrick, Ethel Wiest can be contacted via phone (228) 467-2424.

Contact Information

Primary practice address
412 Highway 90 Suite 10 Bay Saint Louis MS 39520-3534
Phone: (228) 467-2424
Fax: (228) 467-5757
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 45 740 Mississippi
Behavioral Health & Social Service Providers / Psychologist 103T00000X 45 740 Mississippi

Profile Details

NPI number 1699968453
LBN Legal business name Hetrick, Ethel Wiest
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 23rd, 2007
Last updated Jun 24th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699968453 NPPES
Mississippi MEDICAID 02628066

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