Provider Demographics
NPI:1245981364
Name:MUHA, HEATHER BRAUN (LLMSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:BRAUN
Last Name:MUHA
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 E DUCK LAKE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE LEELANAU
Mailing Address - State:MI
Mailing Address - Zip Code:49653-8701
Mailing Address - Country:US
Mailing Address - Phone:231-383-2856
Mailing Address - Fax:231-256-0225
Practice Address - Street 1:7401 E DUCK LAKE RD
Practice Address - Street 2:
Practice Address - City:LAKE LEELANAU
Practice Address - State:MI
Practice Address - Zip Code:49653-8701
Practice Address - Country:US
Practice Address - Phone:231-383-2856
Practice Address - Fax:231-256-0225
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851106773104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6851106773Medicaid