Doctor Name: | KERRY L. HEATH |
NPI Number: | 1033443684 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 0701004466 |
Business Practice Address: | 385 Garrisonville Rd. Suite 113 Stafford, VA - 22554 |
Business Phone Number: | 5406571228 |
Business Fax Number: | 5406571999 |
Mailing Address: | 385 Garrisonville Rd., Suite 113 STAFFORD |
State: | VA |
Postal Code: | 22554 |
Phone Number: | 5406571228 |
Fax Number: | 5406571999 |
NPI Enumeration Date: | 09/30/2009 |
NPI Last Update Date: | 07/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0701004466 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |