Provider Demographics
NPI:1922327105
Name:HETZEL, ANN M (PHD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:HETZEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:691 WESTRAY DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-7701
Mailing Address - Country:US
Mailing Address - Phone:614-808-3632
Mailing Address - Fax:614-452-6188
Practice Address - Street 1:550 S CLEVELAND AVE STE G1
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8958
Practice Address - Country:US
Practice Address - Phone:614-808-3632
Practice Address - Fax:614-452-6188
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6648103TC0700X
OHE.0006439101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional