Provider Demographics
NPI:1255582573
Name:DEAN, HEATHER LYNN (LCSW, LSOTP)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYNN
Last Name:DEAN
Suffix:
Gender:F
Credentials:LCSW, LSOTP
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Mailing Address - Street 1:11999 KATY FWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1611
Mailing Address - Country:US
Mailing Address - Phone:281-755-1365
Mailing Address - Fax:713-583-1835
Practice Address - Street 1:11999 KATY FWY
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1611
Practice Address - Country:US
Practice Address - Phone:281-755-1365
Practice Address - Fax:713-583-1835
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2011-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX366081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196279701Medicaid