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General NPI Number Information
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NPI Number | 1073487336
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Entity Type | Individual
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Provider Name | MRS. HEUREUSE ETIENNE
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Gender | Female
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 602 SIMMONS ST
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City | GOLDSBORO
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State | NC
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Zip | 27530-3748
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Country | US
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Telephone | 617-407-1235
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Fax |
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Provider Business Mailing Address
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Address Line | 402 N LESLIE ST
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City | GOLDSBORO
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State | NC
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Zip | 27530-2872
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Country | US
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Telephone | 617-407-1235
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 000000
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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