Individual
AMANDA KAYE HIETPAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1119 W KENNEDY AVE, KIMBERLY, WI 54136-2214
(920) 470-0754
Mailing address
1119 W KENNEDY AVE, KIMBERLY, WI 54136-2214
(920) 470-0754
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7638-125
WI
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
09/06/2013
Last updated
02/03/2020
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