Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003239195 |
---|---|
Provider Name | Heather Whitney |
First Address | Roseburg, OR 97470-3943 |
Second Address | Roseburg, OR 97470-3943 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2014 |
Last Update Date | 19/02/2014 |