Individual
MRS. HEATHER HETLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
210 S HAWTHORNE DR, SOUTH BEND, IN 46617-3441
(574) 334-8965
Mailing address
210 S HAWTHORNE DR, SOUTH BEND, IN 46617-3441
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005984A
IN
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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