Provider Demographics
NPI:1588288740
Name:HESKETH, KARI LEE
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:LEE
Last Name:HESKETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2636 W WAHISSA TRL
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-9634
Mailing Address - Country:US
Mailing Address - Phone:480-717-1739
Mailing Address - Fax:
Practice Address - Street 1:36275 N GANTZEL RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-7320
Practice Address - Country:US
Practice Address - Phone:480-444-2434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor