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NPI Code Detail

MEDICARE: SHAWN HETZ

MEDICARE: SHAWN HETZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1326446436
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWN HETZ
Provider Business Mailing Address
First Line : 3909 LA PALMA ST
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-8512
Country : US
Telephone Number : 239-247-2690
Fax Number :
Provider Business Practice Location Address
First Line : 3909 LA PALMA ST
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-8512
Country : US
Telephone Number : 239-247-2690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2014
Last Update Date : 12/05/2014

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Directions to “ SHAWN HETZ ” Practice Location

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