Individual
CLINT R HEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, ICADCII
Contact information
Practice address
2855 LAWRENCEVILLE SUWANEE RD STE 330, SUWANEE, GA 30024-3572
(770) 904-3955
Mailing address
333 WOOD CREEK CT, ROSWELL, GA 30076-1998
(044) 606-2138
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1105
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
574369K
—
GA
Enumeration date
10/07/2020
Last updated
10/07/2020
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