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1801358650
MALLORY DIANE HEISE
COLORADO SPRINGS, CO
NPI
1801358650
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-04-02
Last Update Date
2019-04-02
Business Address
MALLORY DIANE HEISE LAC
220 RUSKIN DR
COLORADO SPRINGS, CO 80910-2522
Phone number: 719-314-4277
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Mailing Address
MALLORY DIANE HEISE LAC
220 RUSKIN DR
COLORADO SPRINGS, CO 80910-2522
Phone number: 719-314-4277
Copy
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