Doctor Name: | MRS. MARCIA ANNE HEITZ |
NPI Number: | 1235482365 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 149009968 |
Business Practice Address: | 9706 E Sinnett Chapel Rd Cuba, IL - 614279469 |
Business Phone Number: | 3093383687 |
Business Fax Number: | |
Mailing Address: | 9706 E. Sinnett Chapel Rd., CUBA |
State: | IL |
Postal Code: | 61427 |
Phone Number: | 3093383687 |
Fax Number: | |
NPI Enumeration Date: | 10/26/2012 |
NPI Last Update Date: | 10/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149009968 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |