Provider Demographics
NPI:1619667607
Name:KAMINSKI, HEATHER BETH
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:BETH
Last Name:KAMINSKI
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 1:8318 FLOATING HEART CT
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77385-1128
Mailing Address - Country:US
Mailing Address - Phone:832-458-8669
Mailing Address - Fax:
Practice Address - Street 1:128 VISION PARK BLVD
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3017
Practice Address - Country:US
Practice Address - Phone:832-669-3028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89313101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health