Provider Demographics
NPI:1124451265
Name:HEISS, BRONWYN ELIZABETH (LMHC)
Entity type:Individual
Prefix:
First Name:BRONWYN
Middle Name:ELIZABETH
Last Name:HEISS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4740 N STATE ROAD 7
Mailing Address - Street 2:201
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5839
Mailing Address - Country:US
Mailing Address - Phone:954-486-4005
Mailing Address - Fax:954-497-3857
Practice Address - Street 1:3501 S UNIVERSITY DR
Practice Address - Street 2:6
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2001
Practice Address - Country:US
Practice Address - Phone:954-888-7999
Practice Address - Fax:954-497-3857
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2014-10-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health