| Doctor Name: | DR. ANGELA HEITZMAN |
| NPI Number: | 1780060632 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | |
| Business Practice Address: | 2930 146th St W 114 Rosemount, MN - 550683189 |
| Business Phone Number: | 9524434600 |
| Business Fax Number: | 6513224603 |
| Mailing Address: | 2930 146th St W, 114 ROSEMOUNT |
| State: | MN |
| Postal Code: | 550683189 |
| Phone Number: | 9524434600 |
| Fax Number: | 6513224603 |
| NPI Enumeration Date: | 08/03/2015 |
| NPI Last Update Date: | 08/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |