| NPI | 1992985675 |
|---|---|
| Former Name | HEATHER MARIE DICKINSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 115982) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA LW00009529) |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: MA 215757) | |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2014-06-19 |