Individual
TRICIA MARIE HEATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
8411 BROADWAY AVE, CLEVELAND, OH 44105-3932
(216) 441-0200
Mailing address
8411 BROADWAY AVE, CLEVELAND, OH 44105-3932
(216) 441-0200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
168322
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168322
—
OH
Enumeration date
04/22/2019
Last updated
04/22/2019
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