Individual
DR. KENNETH A HETZLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
123 SUMMER ST, CENTER FOR BEHAVIORAL HEALTH, WORCESTER, MA 01608-1216
(509) 363-5000
Mailing address
123 SUMMER ST, CENTER FOR BEHAVIORAL HEALTH, WORCESTER, MA 01608-1216
(509) 363-5000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
59716
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3045676
—
MA
Enumeration date
08/20/2006
Last updated
02/10/2015
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