Individual
STEPHANIE ELIZABETH HEITMAN-TAGGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
602 OTLEY AVE, PERRY, IA 50220-1088
(515) 992-6638
Mailing address
PO BOX 253, PERRY, IA 50220-0253
(515) 992-6638
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
02778
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1217212358
—
IA
Enumeration date
07/06/2012
Last updated
01/12/2023
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