Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6301010244 | MI |
NPI | 1114067089 |
---|---|
Provider Name | Miss Heather Lynn Scholfield |
First Address | Port Huron, MI 48060-1575 |
Second Address | Port Huron, MI 48060-3838 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 08/07/2007 |