Basic Information
| Provider Information | |||||||||
| NPI: | 1053433177 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEINRICHS | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | PROF. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 113 N.CHRUCH STREET | ||||||||
| Address2: | SUITE 319 | ||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93292 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596361775 | ||||||||
| FaxNumber: | 5596361792 | ||||||||
| Practice Location | |||||||||
| Address1: | 113 N.CHRUCH STREET | ||||||||
| Address2: | SUITE 319 | ||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93292 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596361775 | ||||||||
| FaxNumber: | 5596361792 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.