Individual
MS. KATHLEEN MARY HEFFERNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
18001 N 79TH AVE, B-45, GLENDALE, AZ 85308-8388
(602) 770-4188
(623) 334-6724
Mailing address
2753 E WINDROSE DR, PHOENIX, AZ 85032-6932
(602) 770-4188
(623) 334-6724
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-1748
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806309
—
AZ
Enumeration date
03/30/2007
Last updated
07/09/2007
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