Individual
LEE ELLEN HECKERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
1900 E. WASHINGTON, FREDONIA, KS 66063
(620) 378-3434
Mailing address
4909 SCOTT RD, NEODESHA, KS 66757-1694
(316) 619-1101
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1953
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200740390C
—
KS
05
—
30004252460004
—
KS
Enumeration date
09/20/2006
Last updated
10/07/2024
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