Individual
HEIDI M EASTERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
4216 FLAGSTAFF COVE, HARVEST COUNSELING GROUP INC, FORT WAYNE, IN 46815-4417
(260) 485-4357
(260) 485-4357
Mailing address
4216 FLAGSTAFF COVE, HARVEST COUNSELING GROUP INC, FORT WAYNE, IN 46815-4417
(260) 485-4357
(260) 485-4357
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35001427A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000191132
ANTHEM
—
01
—
373674
VALUE OPTIONS
—
Enumeration date
10/20/2006
Last updated
07/08/2007
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