Individual provider · Type 1 NPI

Mallory Diane Heise, LAC

Addiction (Substance Use Disorder) Counselor · Colorado Springs, CO

NPI number 1801358650 Active

Practice location

220 Ruskin Dr
Colorado Springs, CO 80910-2522

Call (719) 314-4277 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1801358650

Mallory Diane Heise, LAC's National Provider Identifier is 1801358650, issued on Apr 2, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Colorado Springs, CO. The record was last updated on Apr 2, 2019.