Individual
KELLY DENEEN HEINZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED LPC LMFT
Contact information
Practice address
1101 WILSON BLVD, ARLINGTON, VA 22209-2211
(703) 625-4182
Mailing address
3535 36TH RD N, ARLINGTON, VA 22207-4817
(703) 625-4182
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
0701001713
VA
106H00000X
Marriage & Family Therapist
Primary
0717000464
VA
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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