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General NPI Number Information
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NPI Number | 1619667607
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Entity Type | Individual
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Provider Name | HEATHER BETH KAMINSKI
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Gender | Female
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 128 VISION PARK BLVD
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City | SHENANDOAH
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State | TX
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Zip | 77384-3017
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Country | US
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Telephone | 832-669-3028
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Fax |
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Provider Business Mailing Address
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Address Line | 8318 FLOATING HEART CT
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City | CONROE
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State | TX
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Zip | 77385-1128
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Country | US
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Telephone | 832-458-8669
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 89313
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License Number State | TX
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