Individual
GWYN F HEIDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2537 EISENHOWER RD, OTTAWA, KS 66067-9482
(785) 242-2183
(785) 242-1859
Mailing address
13971 W 120TH ST, OLATHE, KS 66062-5691
(913) 782-7380
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW 2354
KS
Other
Enumeration date
10/02/2007
Last updated
10/02/2007
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