Provider Demographics
NPI:1982743167
Name:HEFLIN, PATRICIA LILLIAN (LICENSED COUNSELOR)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LILLIAN
Last Name:HEFLIN
Suffix:
Gender:F
Credentials:LICENSED COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 SHARP MOUNTAIN PKWY
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-8665
Mailing Address - Country:US
Mailing Address - Phone:770-737-2797
Mailing Address - Fax:
Practice Address - Street 1:2920 MARIETTA HWY
Practice Address - Street 2:SUITE 8
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-8212
Practice Address - Country:US
Practice Address - Phone:404-388-9515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001273101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional