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General NPI Number Information
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NPI Number | 1467756122
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Entity Type | Individual
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Provider Name | MELISSA WARREM HEATON LPC
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Gender | Female
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 01/10/2011
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Provider Practice Location Address
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Address Line | 616 N RED RIVER ST
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City | MEXIA
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State | TX
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Zip | 76667-2452
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Country | US
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Telephone | 903-879-4316
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 456
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City | DAWSON
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State | TX
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Zip | 76639-0456
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Country | US
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Telephone | 903-879-4316
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Fax | 254-562-4024
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 57725
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License Number State | TX
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