Individual
DR. DONNA M.L. HERETICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
6451 W PRICKLY PEAR TRL, GLENDALE, AZ 85310-1023
(623) 362-2030
Mailing address
6451 W PRICKLY PEAR TRL, GLENDALE, AZ 85310-1023
(623) 362-2030
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3747
AZ
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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