Provider Demographics
NPI:1326786658
Name:HEROLD, PIPER IV
Entity Type:Individual
Prefix:
First Name:PIPER
Middle Name:
Last Name:HEROLD
Suffix:IV
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 1:2882 W ELLIOTT DR APT H107
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-5809
Mailing Address - Country:US
Mailing Address - Phone:509-363-0831
Mailing Address - Fax:
Practice Address - Street 1:11909 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1903
Practice Address - Country:US
Practice Address - Phone:509-257-3277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician