Individual
MS. LARISSA HEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, LBA, BCBA
Contact information
Practice address
24445 NORTHWESTERN HWY STE 100, SOUTHFIELD, MI 48075-2436
(248) 483-7804
Mailing address
24445 NORTHWESTERN HWY STE 100, SOUTHFIELD, MI 48075-2436
(248) 483-7804
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-21863
MI
1041C0700X
Clinical Social Worker
6801096411
MI
Other
Enumeration date
07/03/2014
Last updated
03/13/2020
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