| Doctor Name: | MICHELLE KATHRYN HEATON |
| NPI Number: | 1821364738 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | 61739-21 |
| Business Practice Address: | 8701 W Watertown Plank Rd Dept Of Psychiatry Milwaukee, WI - 532263548 |
| Business Phone Number: | 4149558998 |
| Business Fax Number: | 4149556299 |
| Mailing Address: | 8701 W Watertown Plank Rd, Dept Of Psychiatry MILWAUKEE |
| State: | WI |
| Postal Code: | 532263548 |
| Phone Number: | 4149558998 |
| Fax Number: | 4149556299 |
| NPI Enumeration Date: | 03/25/2012 |
| NPI Last Update Date: | 05/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 61739-21 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |