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Individual

MRS. ELIZABETH LOUISE HEITZMANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MAC, LPC

Contact information

Practice address
640 S PIER DR, SHEBOYGAN, WI 53081-4986
(920) 698-0019
(920) 803-0337
Mailing address
640 S PIER DR, SHEBOYGAN, WI 53081-4986
(920) 698-0019
(920) 208-7060

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1642-226
WI
101YP2500X
Professional Counselor
103TC1900X
Counseling Psychologist
5630-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000032020
WI
Enumeration date
03/26/2013
Last updated
03/05/2021
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