| Doctor Name: | HEATHER TRAIL |
| NPI Number: | 1316271752 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 0701004655 |
| Business Practice Address: | 770 W Ridge Rd Wytheville, VA - 243821187 |
| Business Phone Number: | 2762233200 |
| Business Fax Number: | 2762230617 |
| Mailing Address: | 770 W Ridge Rd, WYTHEVILLE |
| State: | VA |
| Postal Code: | 243821187 |
| Phone Number: | 2762233200 |
| Fax Number: | 2762230617 |
| NPI Enumeration Date: | 10/01/2009 |
| NPI Last Update Date: | 06/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0701004655 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |