Provider Demographics
NPI:1710930441
Name:DESHONE, HEATHER DANIELLE (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:DANIELLE
Last Name:DESHONE
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 FRANK RD
Mailing Address - Street 2:
Mailing Address - City:FRANKENMUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48734-1210
Mailing Address - Country:US
Mailing Address - Phone:989-652-6847
Mailing Address - Fax:
Practice Address - Street 1:243 CURTISS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BARKSDALE AFB
Practice Address - State:LA
Practice Address - Zip Code:71110-2425
Practice Address - Country:US
Practice Address - Phone:989-652-6847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical