Individual
MIA HECKSTALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BC-DMT
Contact information
Practice address
9544 16TH BAY ST UNIT A, NORFOLK, VA 23518-6214
(757) 981-2742
Mailing address
9544 16TH BAY ST UNIT A, NORFOLK, VA 23518-6214
(757) 981-2742
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BC-DMY-1546
VA
Other
Enumeration date
02/07/2025
Last updated
02/07/2025
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