Individual
AMANDA M. HEITMULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1110 ESTELLE ST, HATTIESBURG, MS 39402-2714
(512) 698-2526
Mailing address
1110 ESTELLE ST, HATTIESBURG, MS 39402-2714
(512) 698-2526
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C7678
MS
Other
Enumeration date
02/14/2014
Last updated
02/14/2014
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