Individual
JESSICA HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAMHC
Contact information
Practice address
6122 RIDGE AVE, PHILADELPHIA, PA 19128-1603
(609) 420-2103
Mailing address
102 MAPLEWOOD DR APT A, MAPLE SHADE, NJ 08052-1971
(609) 420-2103
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/05/2018
Last updated
02/05/2018
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