| NPI | 1225738859 | 
|---|---|
| Former Name | HEATHER ANN SAMPLE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP61678744) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CO61296221) | 
| Enumeration Date | 2023-03-02 | 
| Last Update Date | 2025-07-08 |