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Individual

MS. MEGAN MARIE HEITZMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
1150 5TH ST, SUITE 155, CORALVILLE, IA 52241-2932
(319) 338-2044
Mailing address
1150 5TH ST, SUITE 155, CORALVILLE, IA 52241-2932
(319) 338-2044

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
06081
IA
1041C0700X
Clinical Social Worker
Primary
06081
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
600593449
MAGELLAN BEHAVIORAL HEALTH
IA
01
79141
BLUE CROSS BLUE SHIELD
IA
Enumeration date
12/20/2006
Last updated
02/13/2014
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