Provider Information for 1851710222
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Mr. NEIL TRAVIS HETZEL MS, LPC
Sex: Male
NPI: 1851710222
Last Updated: 2021-05-24
Certification Date: 2021-05-24
Certification Date: 2021-05-24
Details
Name | Value | ||||||||||||
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NPI | 1851710222 | ||||||||||||
Enumeration Date | 2014-04-14 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | YES | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 18843 W LAUREL LN SURPRISE, AZ 85388-3258 United States Phone: 623-466-3482 | Fax:480-963-2036 | ||||||||||||
Primary Practice Address | 18843 W LAUREL LN SURPRISE, AZ 85388-3258 United States Phone: 623-466-3482 | Fax: | ||||||||||||
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