Individual
KODI LYNN HETTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAPC
Contact information
Practice address
623 1/2 N 11TH ST, BISMARCK, ND 58501-4149
(701) 390-4542
Mailing address
623 1/2 N 11TH ST, BISMARCK, ND 58501-4149
(701) 390-4542
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1431-4-1-25A
ND
Other
Enumeration date
04/08/2025
Last updated
04/08/2025
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