Hietpas, Tammy L.

Hietpas, Tammy L. is an individual health care provider with primary practice located at 1095 Midway Rd , Menasha WI 54952. 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. Hietpas, Tammy L. can be contacted via phone (920) 720-2300.

Contact Information

Primary practice address
1095 Midway Rd Menasha WI 54952
Phone: (920) 720-2300
Fax: (920) 720-3719
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 2889-057 Wisconsin
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2889 Wisconsin

Profile Details

NPI number 1396055307
LBN Legal business name Hietpas, Tammy L.
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2010
Last updated Nov 30th, 2018 - about 6 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 1396055307 NPPES
Wisconsin MEDICAID 100011985

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