Tiffany Hetrick | Murray, UT • PECOS Search

Tiffany Hetrick

Social Worker

Behavioral Health & Social Service Providers

5965 S 900 E, Murray, UT 84121-1720

PECOS Enrollment

Based on the most recent information from CMS, provider Tiffany Hetrick does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1073914891
Provider Type
Individual
Full Name
Hetrick, Tiffany
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
9/11/2014
Last Updated
9/11/2014

Contact Information

Practice Location

5965 S 900 E, Murray, UT 84121-1720

Unlisted Fax

Mailing Location

5965 S 900 E, Murray, UT 84121-1720

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 3093010-3501 Utah