| Ethel W Hetrick Phd Pllc | |
|
412 Highway 90 Suite 10 Bay St Louis MS 39520-3534 | |
| (228) 467-2424 | |
| (228) 467-5757 |
| Full Name | Ethel W Hetrick Phd Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 412 Highway 90, Bay St Louis, Mississippi |
| Authorized Official Name and Position | Ethel W Hetrick (PSYCHOLOGIST) |
| Authorized Official Contact | 2284672424 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethel W Hetrick Phd Pllc 412 Highway 90 Suite 10 Bay St Louis MS 39520-3534 Ph: (228) 467-2424 | Ethel W Hetrick Phd Pllc 412 Highway 90 Suite 10 Bay St Louis MS 39520-3534 Ph: (228) 467-2424 |
| NPI Number | 1215342514 |
|---|---|
| Provider Enumeration Date | 06/25/2014 |
| Last Update Date | 06/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215342514 | NPI | - | NPPES |
| 02628066 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 45 740 (Mississippi) | Primary |
Serenity Now Healthcare Of Ms Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5011 Virginia St, Bay St Louis, MS 39520 Phone: 888-371-1924 Fax: 888-371-1924 | |
Changing Minds, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 835 Highway 90 Ste 12, Bay St Louis, MS 39520 Phone: 228-463-2680 |