Provider Demographics
NPI:1356783799
Name:HEINTZ, ALISON E (MSAT)
Entity type:Individual
Prefix:MISS
First Name:ALISON
Middle Name:E
Last Name:HEINTZ
Suffix:
Gender:F
Credentials:MSAT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:E
Other - Last Name:JANZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSAT
Mailing Address - Street 1:203600 SUN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:WI
Mailing Address - Zip Code:54479-5500
Mailing Address - Country:US
Mailing Address - Phone:715-897-7761
Mailing Address - Fax:
Practice Address - Street 1:203600 SUN RIDGE DR
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:WI
Practice Address - Zip Code:54479-5500
Practice Address - Country:US
Practice Address - Phone:715-897-7761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5776101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional