Individual
RICHARD A. HEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
111 W PORT PLZ STE 600, SAINT LOUIS, MO 63146-3015
(314) 399-9707
(314) 474-0119
Mailing address
111 W PORT PLZ STE 600, SAINT LOUIS, MO 63146-3015
(314) 399-9707
(314) 474-0119
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
R0350
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497724906
—
MO
Enumeration date
06/29/2006
Last updated
02/21/2023
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