Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 1408 | CO |
NPI | 1174670558 |
---|---|
Provider Name | Dr. Bruce R Heany |
First Address | Northglenn, CO 80234 |
Second Address | Northglenn, CO 80234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 13/11/2015 |