Individual
MRS. CHARLOTTE JENICE HERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA PSYCHOLOGY
Contact information
Practice address
8284 28TH CT NE STE A, LACEY, WA 98516-7161
(360) 559-1506
Mailing address
8284 28TH CT NE STE A, LACEY, WA 98516-7161
(360) 559-1506
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MG60660327
WA
106H00000X
Marriage & Family Therapist
Primary
LF61546501
WA
Other
Enumeration date
05/18/2015
Last updated
08/11/2024
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