Individual
KAYLEEN HETRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
491 N KNIK ST, WASILLA, AK 99654-7049
(907) 232-9501
(907) 376-9507
Mailing address
491 N KNIK ST, WASILLA, AK 99654-7049
(907) 232-9501
(907) 376-9507
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
92
AK
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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