Individual
JANE IRENE HEATHCOTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10010 KENNERLY RD, HYLAND BEHAVIORAL HEALTH, SAINT LOUIS, MO 63128-2106
(314) 525-1000
Mailing address
7032 CIRCLEVIEW DR, SAINT LOUIS, MO 63123-1602
(314) 752-1784
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004739
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004739
LICENSE NUMBER LCSW
MO
Enumeration date
06/26/2007
Last updated
07/08/2007
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