Organization
MARK F HEILAND, PHD, LICENSED PSYCHOLOGIST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK F HEILAND PHD (PSYCHOLOGIST)
(314) 609-5532
Entity
Organization
Contact information
Practice address
4542 W PINE BLVD, SAINT LOUIS, MO 63108-2186
(314) 609-5532
Mailing address
4542 WEST PINE BLVD, ST LOUIS, MO 63104
(314) 609-5532
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2009018630
MO
Other
Enumeration date
02/25/2012
Last updated
02/25/2012
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