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Individual

MARVA A HEINEMANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, LMFT, RN

Contact information

Practice address
RR 5 BOX 170, IDABEL, OK 74745-9110
(580) 286-5050
(580) 286-2273
Mailing address
RR 5 BOX 170, P. O. BOX 615, IDABEL, OK 74745-9110
(580) 286-5050
(580) 286-2273

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
136
OK

Other

Enumeration date
08/06/2006
Last updated
07/08/2007
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