Provider Demographics
NPI:1629695671
Name:HETZEL, CATHERINE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:HETZEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N52W14205 ABERDEEN DR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-6865
Mailing Address - Country:US
Mailing Address - Phone:414-902-3044
Mailing Address - Fax:
Practice Address - Street 1:300 N 3RD ST STE 112
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53094-3723
Practice Address - Country:US
Practice Address - Phone:920-545-4357
Practice Address - Fax:920-390-4272
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional