Individual
JERRY W HEIDERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
723 S I 35 E STE 110, DENTON SQUARE BUSINESS CENTER, DENTON, TX 76205-4102
(940) 483-1789
Mailing address
505 FAIRWAY MEADOWS DR, GARLAND, TX 75044-5069
(214) 862-8964
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4760
TX
Other
Enumeration date
09/17/2014
Last updated
09/17/2014
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