Provider Demographics
NPI:1215287453
Name:HECHT, TRISTIN A (HIS)
Entity type:Individual
Prefix:
First Name:TRISTIN
Middle Name:A
Last Name:HECHT
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 GREEN AVE
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-4045
Mailing Address - Country:US
Mailing Address - Phone:307-689-3611
Mailing Address - Fax:
Practice Address - Street 1:300 GREEN AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-4045
Practice Address - Country:US
Practice Address - Phone:307-689-3611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY178237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist