Doctor Name: | LYNETTE R HECKENBERG |
NPI Number: | 1003895806 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 00820 |
Business Practice Address: | 610 N 4th St Suite 110a Burlington, IA - 526015055 |
Business Phone Number: | 3197548035 |
Business Fax Number: | 3197549213 |
Mailing Address: | 610 N 4th St, Suite 110a BURLINGTON |
State: | IA |
Postal Code: | 526015055 |
Phone Number: | 3197548035 |
Fax Number: | 3197549213 |
NPI Enumeration Date: | 01/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 00820 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |