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Individual

MRS. JESSICA LYNN HETMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.ED.

Contact information

Practice address
42 TIPTON DR W, SHIRLEY, NY 11967-3509
(631) 657-3433
(631) 657-3433
Mailing address
42 TIPTON DR W, SHIRLEY, NY 11967-3509
(631) 657-3433
(631) 657-3433

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
1759381
NY
224Z00000X
Occupational Therapy Assistant
Primary
009487
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1759381
PRE-KINDERGARTEN, KINDERGARTEN & GRADES 1-6, PERMANENT
NY
Enumeration date
04/21/2009
Last updated
09/19/2017
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