Doctor Name: | MS. NICOLE HEIMDAL |
NPI Number: | 1629491261 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 00117978 |
Business Practice Address: | 625 Slawin Ct Mount Prospect, IL - 600562183 |
Business Phone Number: | 3127300361 |
Business Fax Number: | 2249997566 |
Mailing Address: | 8836 Grand Ave, RIVER GROVE |
State: | IL |
Postal Code: | 601711347 |
Phone Number: | 3127300361 |
Fax Number: | 2249997566 |
NPI Enumeration Date: | 02/03/2014 |
NPI Last Update Date: | 02/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 00117978 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
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 |