Provider Demographics
NPI:1194468611
Name:HEINRICH, KATHERINE (LAC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:HEINRICH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 N SHERMAN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2298
Mailing Address - Country:US
Mailing Address - Phone:443-717-0606
Mailing Address - Fax:
Practice Address - Street 1:1155 N SHERMAN ST STE 101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2298
Practice Address - Country:US
Practice Address - Phone:443-717-0606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002590171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist