Hettrick, Ivy L

Hettrick, Ivy L is an individual health care provider with primary practice located at 440 Edmond Dr , Dyer IN 46311-1523. She recently has only one registered license in Nursing Service Related Providers / Day Training/Habilitation Specialist, which is considered as her primary health care specialty. Hettrick, Ivy L can be contacted via phone (219) 322-1415.

Contact Information

Primary practice address
440 Edmond Dr Dyer IN 46311-1523
Phone: (219) 322-1415
Fax: (219) 322-1414
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Day Training/Habilitation Specialist 373H00000X

Profile Details

NPI number 1689614257
LBN Legal business name Hettrick, Ivy L
Credentials MS ED
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Sep 2nd, 2008 - about 16 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 1689614257 NPPES
Indiana MEDICAID 200680450

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