Individual
MRS. CAROL SUE HEAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC, TA
Contact information
Practice address
10500 WOODMAN ST, MABELVALE, AR 72103-1789
(501) 247-1456
Mailing address
11201 HEINKE RD, MABELVALE, AR 72103-2048
(501) 455-5793
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A1707234
AR
Other
Enumeration date
10/25/2019
Last updated
10/25/2019
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