Provider Demographics
NPI:1861871360
Name:HECKLER, MEREDITH (MA, MFT)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:HECKLER
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 W RIVERSIDE DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4073
Mailing Address - Country:US
Mailing Address - Phone:818-205-5572
Mailing Address - Fax:
Practice Address - Street 1:4444 W RIVERSIDE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4073
Practice Address - Country:US
Practice Address - Phone:818-205-5572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50426106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist