| NPI | 1073886107 |
|---|---|
| Former Name | STACEY L HEINDL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WI 7889-123) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16529-130) | |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2013-04-17 |