Individual
KELLY L HEENAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3741 ARROYO DRIVE, CASPER, WY 82604
(307) 472-2995
Mailing address
3741 ARROYO DRIVE, CASPER, WY 82604
(307) 472-2995
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
62396
TX
101YP2500X
Professional Counselor
LPC - 1073
WY
106H00000X
Marriage & Family Therapist
201042
TX
106H00000X
Marriage & Family Therapist
Primary
LMFT -139
WY
Other
Enumeration date
04/10/2007
Last updated
10/21/2011
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