Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003190703 |
---|---|
Provider Name | Mrs. Heather Lynn Rimes |
First Address | Lakeland, FL 33813-3734 |
Second Address | Lakeland, FL 33813-3734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2011 |
Last Update Date | 29/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000 | (05) | FL |