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DANIELLE LORRAINE HEITMAN
>> Marriage & Family Therapist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1528298890
Individual Registrant: DANIELLE LORRAINE HEITMAN
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
9495 MAIN ST # 6 UPPER LAKE, CA 95485-9603 US
Tel: 707-500-2315 Fax: --
Tel: 707-500-2315 Fax: --
Contact information for business:
PO BOX 396 UPPER LAKE, CA 95485-0396 US
Tel: 707-500-2315 Fax: --
Tel: 707-500-2315 Fax: --
Registration Information:
NPI: 1528298890
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 106H00000X | Behavioral Health & Social Service Providers Marriage & Family Therapist | CA | 97274 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
