Provider Demographics
NPI:1326490764
Name:HEUTON, SATRINA
Entity Type:Individual
Prefix:MRS
First Name:SATRINA
Middle Name:
Last Name:HEUTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27979 TAVISTOCK TRL
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-2101
Mailing Address - Country:US
Mailing Address - Phone:248-469-2579
Mailing Address - Fax:
Practice Address - Street 1:27979 TAVISTOCK TRL
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-2101
Practice Address - Country:US
Practice Address - Phone:248-469-2579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801099414104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker