Doctor Name: | ALEXIS G HEITMAN |
NPI Number: | 1134454556 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC, LCDP |
License Number: | CDP00470 |
Business Practice Address: | 4705a Old Post Rd Charlestown, RI - 028131819 |
Business Phone Number: | 4013647705 |
Business Fax Number: | 4013649104 |
Mailing Address: | 4705a Old Post Rd, CHARLESTOWN |
State: | RI |
Postal Code: | 028131819 |
Phone Number: | 4013647705 |
Fax Number: | 4013649104 |
NPI Enumeration Date: | 10/04/2009 |
NPI Last Update Date: | 03/28/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | CDP00470 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | RI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |