Provider Demographics
NPI:1265603344
Name:THOMAS, HEATHER ANN (MED)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:ANN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 FOWLER ST
Mailing Address - Street 2:STE 31
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4833
Mailing Address - Country:US
Mailing Address - Phone:509-845-1021
Mailing Address - Fax:509-627-1523
Practice Address - Street 1:1776 FOWLER ST
Practice Address - Street 2:STE 31
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4833
Practice Address - Country:US
Practice Address - Phone:509-845-1021
Practice Address - Fax:509-627-1523
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00041199101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health