Provider Demographics
NPI:1922712900
Name:WOOLEY, HEIDI NICOLE (CBHP)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:NICOLE
Last Name:WOOLEY
Suffix:
Gender:F
Credentials:CBHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5790 GREAT NORTHERN BLVD APT F3
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-5607
Mailing Address - Country:US
Mailing Address - Phone:440-371-0590
Mailing Address - Fax:
Practice Address - Street 1:5790 GREAT NORTHERN BLVD APT F3
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-5607
Practice Address - Country:US
Practice Address - Phone:440-371-0590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRS044275OtherDRIVERS LICENSE NUMBER