Individual
STEPHANIE HEFFNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA NCC LPC-C
Contact information
Practice address
300 N DALTON ST, VALLIANT, OK 74764-8029
(580) 933-7031
(580) 933-7034
Mailing address
300 N DALTON ST, VALLIANT, OK 74764-8029
(580) 933-7031
(580) 933-7034
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780929703
—
OK
Enumeration date
12/03/2012
Last updated
10/03/2019
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