Kelly Lorene Heimdahl

NPI #1003519323 in Azusa, California

Provider Information

NPI Number: 1003519323
Entity Type: Individual
Name: Kelly Lorene Heimdahl
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: Mar 24, 2023
Last Updated: Mar 24, 2023

Practice Location

Address: 23701 E EAST FORK RD
City: Azusa
State: California
ZIP Code: 91702-1477
Phone: (626) 250-3290

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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