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General NPI Number Information
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NPI Number | 1972913598
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Entity Type | Individual
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Provider Name | LORIANN HETTERLE
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Gender | Female
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 03/30/2020
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Provider Practice Location Address
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Address Line | 18 E STATE ST STE 206
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City | REDLANDS
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State | CA
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Zip | 92373-4773
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Country | US
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Telephone | 303-507-0925
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Fax |
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Provider Business Mailing Address
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Address Line | 25745 BARTON RD # 351
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City | LOMA LINDA
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State | CA
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Zip | 92354-3812
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Country | US
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Telephone | 909-681-1750
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0011927
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3809
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License Number State | CA
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