Individual
CHRISTIAN D HEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 N BROADWAY ST, SUITE 1, POTEAU, OK 74953-2617
(918) 649-0772
Mailing address
PO BOX 1335, POTEAU, OK 74953-1335
(918) 649-0772
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
57321
CA
106H00000X
Marriage & Family Therapist
Primary
51312
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295909349
—
CA
Enumeration date
04/19/2008
Last updated
03/31/2014
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