Provider Demographics
NPI:1265455125
Name:HEITZMAN, ARTHUR LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:LYNN
Last Name:HEITZMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 N MCCORMICK ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-2723
Mailing Address - Country:US
Mailing Address - Phone:928-778-9077
Mailing Address - Fax:928-541-9364
Practice Address - Street 1:143 N MCCORMICK ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-2723
Practice Address - Country:US
Practice Address - Phone:928-778-9077
Practice Address - Fax:928-541-9364
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3806103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist