Provider Demographics
NPI:1013770478
Name:REID, HEATHER KRISTINE (LMSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:KRISTINE
Last Name:REID
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 LONG MEADOW TRL
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-9633
Mailing Address - Country:US
Mailing Address - Phone:313-404-3482
Mailing Address - Fax:
Practice Address - Street 1:1517 LONG MEADOW TRL
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-9633
Practice Address - Country:US
Practice Address - Phone:313-404-3482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011154181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical