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General NPI Number Information
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NPI Number | 1033597000
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Entity Type | Organization
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Legal Business Name | BROOKE J HEPPNER MFT
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 6711 W. 121ST STREET SUITE 101
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City | OVERLAND PARK
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State | KS
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Zip | 66209
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Country | US
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Telephone | 913-214-2995
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Fax |
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Provider Business Mailing Address
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Address Line | 6711 W. 121ST STREET SUITE 101
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City | OVERLAND PARK
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State | KS
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Zip | 66209
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Country | US
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Telephone | 913-214-2995
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | BROOKE J HEPPNER
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Credential | LMFT
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Telephone | 626-765-4097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT86409
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License Number State | CA
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