Provider Demographics
NPI:1437869187
Name:HEHER, KELLY
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:HEHER
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 1:1333 NW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-1482
Mailing Address - Country:US
Mailing Address - Phone:541-447-2631
Mailing Address - Fax:
Practice Address - Street 1:215 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2113
Practice Address - Country:US
Practice Address - Phone:541-388-8459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional