Provider Demographics
NPI:1891805743
Name:MCNALLY, HEATHER (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:HOLLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8861 WILLIAMSON DR STE 40
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1878
Mailing Address - Country:US
Mailing Address - Phone:916-685-5258
Mailing Address - Fax:916-670-7880
Practice Address - Street 1:8861 WILLIAMSON DR STE 40
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1878
Practice Address - Country:US
Practice Address - Phone:916-685-5258
Practice Address - Fax:916-670-7880
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 42294106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist