Provider Demographics
NPI:1619754561
Name:WILKIE, HEATHER L (LMHC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:WILKIE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1839 PEARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-5837
Mailing Address - Country:US
Mailing Address - Phone:407-399-0774
Mailing Address - Fax:
Practice Address - Street 1:1839 PEARWOOD CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-5837
Practice Address - Country:US
Practice Address - Phone:407-399-0774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH20343101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health