Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 6401014661 | MI |
N | 101YP2500X | Professional Counselor | 6401014661 | MI |
NPI | 1003208364 |
---|---|
Provider Name | Robyn Heiler |
First Address | Grand Blanc, MI 48439-2077 |
Second Address | Grand Blanc, MI 48439-2077 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2015 |
Last Update Date | 04/10/2018 |