Provider Demographics
NPI:1114949229
Name:HEITMAN, SARA (MA, LLP,CAADC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HEITMAN
Suffix:
Gender:F
Credentials:MA, LLP,CAADC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:HEITMAN
Other - Last Name:GUETZKOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1460 WALTON BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1779
Mailing Address - Country:US
Mailing Address - Phone:248-824-2538
Mailing Address - Fax:
Practice Address - Street 1:1460 WALTON BLVD STE 120
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-1779
Practice Address - Country:US
Practice Address - Phone:248-844-6234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009640103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist