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Individual

KEISHA MALIA HEARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
118 E CHOCCOLOCCO ST, OXFORD, AL 36203-1222
(256) 831-4601
(256) 835-3386
Mailing address
1722A CIRCLE DR, OXFORD, AL 36203-3210
(256) 225-3716

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
104100000X
Social Worker

Other

Enumeration date
06/15/2020
Last updated
06/15/2020
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