Individual
MS. CARROLYN JEAN HETTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1226 AMARILLO ST, ABILENE, TX 79602-3504
(325) 677-5595
Mailing address
1226 AMARILLO ST, ABILENE, TX 79602-3504
(325) 677-5595
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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