Doctor Name: | SANDY J HEILMAN |
NPI Number: | 1962565655 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | LH00007679 |
Business Practice Address: | 322 Fortuyn Rd Grand Coulee, WA - 99133 |
Business Phone Number: | 5096331471 |
Business Fax Number: | 5096332148 |
Mailing Address: | P.o. Box 1057, MOSES LAKE |
State: | WA |
Postal Code: | 98837 |
Phone Number: | 5097659239 |
Fax Number: | 5097651582 |
NPI Enumeration Date: | 12/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH00007679 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |