Provider Demographics
NPI:1003208364
Name:HEILER, ROBYN
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:HEILER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8341 OFFICE PARK DR STE E
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2077
Mailing Address - Country:US
Mailing Address - Phone:248-602-2593
Mailing Address - Fax:
Practice Address - Street 1:8341 OFFICE PARK DR STE E
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2077
Practice Address - Country:US
Practice Address - Phone:989-413-6110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014661101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional