Individual
WALTER HEIZENROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 BLACKHORSE HILL RD, COATESVILLE, PA 19320-2040
(610) 384-7711
Mailing address
6 WOODVIEW RD, MALVERN, PA 19355-2119
(610) 948-0981
(610) 948-1464
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS005637L
PA
Other
Enumeration date
08/11/2006
Last updated
10/18/2016
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