Doctor Name: | MRS. HEATHER VINSON BOAN |
NPI Number: | 1740427020 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 00005 |
Business Practice Address: | 310 Nw Backwoods Rd Moyock, NC - 279588668 |
Business Phone Number: | 2522324049 |
Business Fax Number: | 2522324049 |
Mailing Address: | 310 Nw Backwoods Rd, MOYOCK |
State: | NC |
Postal Code: | 279588668 |
Phone Number: | 2522324049 |
Fax Number: | 2522324049 |
NPI Enumeration Date: | 01/08/2009 |
NPI Last Update Date: | 01/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YS0200X |
License Number: | 00005 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | School |
Taxonomy Definition: |