Individual
ANNELISE P HEITMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
401 E 10TH AVE, SUITE 330, EUGENE, OR 97401-3317
(541) 868-2004
Mailing address
1672 WILSON CT, EUGENE, OR 97402-3361
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0723
OR
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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