NPI | 1649354978 |
---|---|
Former Name | KIMBERLY MARIE HEINEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 70303) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 17539) |
Enumeration Date | 2006-10-24 |
Last Update Date | 2021-01-22 |