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Individual

DR. AMANDA MARIE HEINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
4555 W SCHROEDER DR, BROWN DEER, WI 53223-1475
(414) 355-9000
(414) 355-9665
Mailing address
4555 W SCHROEDER DR, BROWN DEER, WI 53223-1475
(414) 355-9000
(414) 355-9665

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
103T00000X
Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101314758
WI
01
12317640
CAQH
WI
Enumeration date
07/24/2009
Last updated
03/01/2015
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