| 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 |