Individual
NICOLE ANN HEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
518 6TH ST STE 4, RAPID CITY, SD 57701-5000
(605) 939-0340
Mailing address
PO BOX 3634, RAPID CITY, SD 57709-3634
(605) 645-3373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC20383
SD
Other
Enumeration date
05/27/2019
Last updated
05/27/2019
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