Individual
EILEEN HEASTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
612 W 18TH AVE, ANCHORAGE, AK 99503-1826
(907) 903-3507
Mailing address
612 W 18TH AVE, ANCHORAGE, AK 99503-1826
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
785
AK
Other
Enumeration date
04/25/2013
Last updated
04/25/2013
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