Individual
MICHELLE S HERTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
801 ROAD TO SIX FLAGS W, ARLINGTON, TX 76012-2616
(817) 795-3030
(817) 795-3099
Mailing address
3001A W 5TH ST, FORT WORTH, TX 76107-2206
(817) 338-0311
(817) 332-9075
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12420
TEXAS DEPT OF STATE HEALTH SERVICES
TX
Enumeration date
11/07/2017
Last updated
03/17/2018
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