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General NPI Number Information
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NPI Number | 1598016016
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Entity Type | Individual
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Provider Name | ELIZABETH HEGLIN
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Gender | Female
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Dates
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Enumeration Date | 09/24/2012
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Last Update Date | 09/24/2012
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Provider Practice Location Address
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Address Line | 801 7TH ST
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City | DAVENPORT
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State | WA
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Zip | 99122-8676
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Country | US
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Telephone | 509-725-1481
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2186
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City | DEER PARK
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State | WA
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Zip | 99006-2186
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Country | US
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Telephone | 509-294-9374
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 491464D
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License Number State | WA
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