Doctor Name: | KAREN JO HEINRICH |
NPI Number: | 1548304306 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 6401006724 |
Business Practice Address: | 2348 E Huron Rd Au Gres, MI - 487039419 |
Business Phone Number: | 9893628636 |
Business Fax Number: | |
Mailing Address: | 2348 E Huron Rd, AU GRES |
State: | MI |
Postal Code: | 487039419 |
Phone Number: | 9893628636 |
Fax Number: | |
NPI Enumeration Date: | 02/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6401006724 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |