Individual
MR. MARK ANTHONY HEILMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1360
(208) 422-1323
Mailing address
11001 RUNWAY DR, BOISE, ID 83714
(208) 938-1426
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-354
ID
Other
Enumeration date
08/12/2006
Last updated
07/08/2007
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