Individual
ETHAN HEINEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3000 LATROBE DR STE B, CHARLOTTE, NC 28211-5227
(704) 780-4271
(888) 261-6694
Mailing address
12734 SETTLERS PATH LN, CHARLOTTE, NC 28278-7682
(336) 312-0933
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NC
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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