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NPI Code Detail

MEDICARE: HEATHER MARIE CAINE LADC

MEDICARE: HEATHER MARIE CAINE LADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor302269MN

General Provider Information

NPI Number : 1124203765
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER MARIE CAINE LADC
Provider Business Mailing Address
First Line : 343 WOODLAKE DR SE
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-6242
Country : US
Telephone Number : 507-535-5714
Fax Number :
Provider Business Practice Location Address
First Line : 343 WOODLAKE DR SE
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-6242
Country : US
Telephone Number : 507-535-5714
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2008
Last Update Date : 01/02/2008

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Directions to “ HEATHER MARIE CAINE LADC” Practice Location

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