Individual
MICHELLE KATHRYN HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
721 AMERICAN AVE STE 501, WAUKESHA, WI 53188-5071
(262) 928-4036
Mailing address
721 AMERICAN AVE STE 501, WAUKESHA, WI 53188-5071
(262) 928-4036
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
61739
WI
208D00000X
General Practice Physician
61739-21
WI
Other
Enumeration date
03/25/2012
Last updated
11/27/2024
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