Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | 10082 | WA |
NPI | 1114298288 |
---|---|
Provider Name | Heidi Brown |
First Address | Dryden, WA 98821-0002 |
Second Address | Cashmere, WA 98815-1001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2012 |
Last Update Date | 22/01/2012 |