Individual
MARY LOUISA HEINEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
200 E NORTHWOOD ST, SUITE 508, GREENSBORO, NC 27401
(336) 275-9889
(336) 275-9880
Mailing address
107 E NEWLYN ST, GREENSBORO, NC 27408
(336) 273-2930
(336) 273-2930
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
518
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107159
—
NC
Enumeration date
09/26/2006
Last updated
07/08/2007
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