Individual
MRS. JODIE REBECCA HEICKLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
17344 W 12 MILE RD STE 207, SOUTHFIELD, MI 48076-6321
(917) 536-2330
Mailing address
25507 HEREFORD DR, HUNTINGTON WOODS, MI 48070-1639
(917) 536-2330
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801093976
MI
Other
Enumeration date
05/17/2018
Last updated
05/17/2018
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