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Organization

NICOLE HEFFRON, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NICOLE ENGLUND HEFFRON PH.D. (LICENSED PSYCHOLOGIST)
(651) 224-1541
Entity
Organization

Contact information

Practice address
889 GRAND AVE, SUITE 202, SAINT PAUL, MN 55105-3008
(651) 224-1541
(651) 224-3501
Mailing address
889 GRAND AVE, SUITE 202, SAINT PAUL, MN 55105-3008
(651) 224-1541
(651) 224-3501

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP 4508
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
148445100
MN
01
572G1EN
BLUE CROSS BLUE SHEILD
MN
Enumeration date
06/29/2009
Last updated
06/29/2009
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