Basic Information
| Provider Information | |||||||||
| NPI: | 1336209444 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEUVELHORST | ||||||||
| FirstName: | EILEEN | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A., L.L.P | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 S 3RD AVE | ||||||||
| Address2: | |||||||||
| City: | BIG RAPIDS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 493079501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317963553 | ||||||||
| FaxNumber: | 2317962409 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 S 3RD AVE | ||||||||
| Address2: | |||||||||
| City: | BIG RAPIDS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 493079501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317963553 | ||||||||
| FaxNumber: | 2317962409 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 6301008879 | MI | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.