Doctor Name: | HEATHER V. DISTIN |
NPI Number: | 1295961845 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCC |
License Number: | E.0501357 |
Business Practice Address: | 347 Midway Blvd #200 Elyria, OH - 44035 |
Business Phone Number: | 4403245701 |
Business Fax Number: | 4403249978 |
Mailing Address: | 347 Midway Blvd, #200 ELYRIA |
State: | OH |
Postal Code: | 44035 |
Phone Number: | 4403245701 |
Fax Number: | 4403249978 |
NPI Enumeration Date: | 06/09/2009 |
NPI Last Update Date: | 06/15/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | E.0501357 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |