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General NPI Number Information
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NPI Number | 1366827487
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Entity Type | Organization
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Legal Business Name | HEALING FROM THE HEART
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Dates
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Enumeration Date | 07/30/2015
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Last Update Date | 07/30/2015
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Provider Practice Location Address
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Address Line | 5425 NE 27TH AVE
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City | PORTLAND
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State | OR
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Zip | 97211-6227
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Country | US
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Telephone | 971-275-9974
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Fax |
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Provider Business Mailing Address
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Address Line | 5425 NE 27TH AVE
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City | PORTLAND
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State | OR
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Zip | 97211-6227
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Country | US
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Telephone | 971-275-9974
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MS. JAVELIN L HARDY
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Credential | CSWA
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Telephone | 971-275-9974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | A5513
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License Number State | OR
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