Provider Demographics
NPI:1215419742
Name:WALDVOGEL, HEATHER JUNE (MS, LPC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:JUNE
Last Name:WALDVOGEL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 RANCH AVE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-1432
Mailing Address - Country:US
Mailing Address - Phone:405-564-3896
Mailing Address - Fax:
Practice Address - Street 1:619 RANCH AVE
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-1432
Practice Address - Country:US
Practice Address - Phone:405-564-3896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health