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General NPI Number Information
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NPI Number | 1235678806
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Entity Type | Organization
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Legal Business Name | HEATHER HERRICK, LMSW, PLLC
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 2311 SHELBY AVE STE 101D
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City | ANN ARBOR
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State | MI
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Zip | 48103-3849
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Country | US
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Telephone | 734-355-1585
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Fax |
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Provider Business Mailing Address
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Address Line | 4312 CLOVERLANE DR
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City | YPSILANTI
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State | MI
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Zip | 48197-5058
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Country | US
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Telephone | 734-355-1585
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HEATHER A HERRICK
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Credential | LMSW
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Telephone | 734-355-1585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6801084407
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License Number State | MI
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