Doctor Name: | DAWN L HECKENKAMP |
NPI Number: | 1053656470 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 4110-125 |
Business Practice Address: | 708 Elizabeth St Baraboo, WI - 539132372 |
Business Phone Number: | 6084779858 |
Business Fax Number: | 8775600578 |
Mailing Address: | 708 Elizabeth St, BARABOO |
State: | WI |
Postal Code: | 539132372 |
Phone Number: | 6084779858 |
Fax Number: | 8775600578 |
NPI Enumeration Date: | 12/11/2012 |
NPI Last Update Date: | 12/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4110-125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |