Provider Information for 1588214639
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KATHRYN HEINZEN LPC
Sex: Female
NPI: 1588214639
Last Updated: 2019-09-19
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1588214639 | ||||||||
| Enumeration Date | 2019-09-19 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 20405 HILLTOP RD REEDSVILLE, WI 54230-9215 United States Phone: 262-707-6747 | Fax: | ||||||||
| Primary Practice Address | 9003 POLIFKA RD WHITELAW, WI 54247-9782 United States Phone: 262-707-6747 | Fax: | ||||||||
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