| Doctor Name: | MISS LISA HEIDEN |
| NPI Number: | 1114321593 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S PLMHP |
| License Number: | 10382 |
| Business Practice Address: | 965 Patricia Dr Papillion, NE - 680462922 |
| Business Phone Number: | 4029327788 |
| Business Fax Number: | |
| Mailing Address: | 965 Patricia Dr, PAPILLION |
| State: | NE |
| Postal Code: | 680462922 |
| Phone Number: | 4029327788 |
| Fax Number: | |
| NPI Enumeration Date: | 10/14/2014 |
| NPI Last Update Date: | 10/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 10382 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |