Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1336610765 |
---|---|
Provider Name | Heidi Picord |
First Address | Iron Mountain, MI 49801-4760 |
Second Address | Iron Mountain, MI 49801-4760 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2018 |
Last Update Date | 11/12/2018 |