Provider Demographics
NPI:1659732477
Name:HESTON, JENNIFER (CDP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HESTON
Suffix:
Gender:F
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-3248
Mailing Address - Country:US
Mailing Address - Phone:714-737-0171
Mailing Address - Fax:
Practice Address - Street 1:1914 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3248
Practice Address - Country:US
Practice Address - Phone:714-737-0171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)