Individual
THEODORE HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
315 N MAIN ST, ANN ARBOR, MI 48104-1133
(734) 821-0216
Mailing address
6633 STONY CREEK RD, YPSILANTI, MI 48197-6609
(734) 485-8725
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/11/2019
Last updated
10/11/2019
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