Individual
DIANE MARIE HIETPAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, SAC
Contact information
Practice address
W3275 WOLF RIVER DR, KESHENA, WI 54135-9202
(715) 799-5400
(715) 799-1326
Mailing address
PO BOX 970, KESHENA, WI 54135-0970
(715) 799-5400
(715) 799-1326
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16529-131
WI
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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