Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6401012512 | MI |
NPI | 1003103912 |
---|---|
Provider Name | Mrs. Megan L Hebert |
First Address | Sterling Heights, MI 48312-4511 |
Second Address | Clinton Twp, MI 48038-5036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2011 |
Last Update Date | 16/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
750910402 | BLUE CROSS (01) | MI |