Provider Demographics
NPI:1710486675
Name:HIGH, HEATHER IRENE (MS BEHAVIOR SCIENC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:IRENE
Last Name:HIGH
Suffix:
Gender:F
Credentials:MS BEHAVIOR SCIENC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10650 NE MANOR LN
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1120
Mailing Address - Country:US
Mailing Address - Phone:360-626-3697
Mailing Address - Fax:
Practice Address - Street 1:10650 NE MANOR LN
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1120
Practice Address - Country:US
Practice Address - Phone:360-626-3697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-06
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARBT-15-09999106S00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician