Individual
KELLY HEINZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 W LAKEWAY RD STE 1004, GILLETTE, WY 82718-6349
(307) 363-4400
Mailing address
509 HUNT AVE, GILLETTE, WY 82716-3538
(307) 670-1648
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PPC-1522
WY
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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