Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1073855078 |
---|---|
Provider Name | Ms. Jennifer Marie Heil |
First Address | Scottsdale, AZ 85259-5525 |
Second Address | Scottsdale, AZ 85259-5525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2013 |
Last Update Date | 18/03/2013 |