Individual
RITA HEINZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
33 N CENTRAL AVE, MEDFORD, OR 97501-5900
(541) 512-0615
Mailing address
210 SUNCREST RD, SUITE 3, TALENT, OR 97540-8691
(541) 512-0615
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L0771
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274896
—
OR
Enumeration date
03/02/2007
Last updated
04/22/2009
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