Provider Demographics
NPI:1790177186
Name:DI BIASE, HEATHER (MSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:DI BIASE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 E 53RD AVE
Mailing Address - Street 2:APT H105
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-7997
Mailing Address - Country:US
Mailing Address - Phone:509-368-4121
Mailing Address - Fax:
Practice Address - Street 1:707 W 7TH AVE
Practice Address - Street 2:STE 294
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2833
Practice Address - Country:US
Practice Address - Phone:509-368-4121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-23
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604434691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical