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General NPI Number Information
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NPI Number | 1992976450
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Entity Type | Individual
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Provider Name | HEIDI GAIL CHAMBERS M.A.
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Gender | Female
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 09/15/2010
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Provider Practice Location Address
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Address Line | 103 S 4TH ST STE 202
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City | SHELTON
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State | WA
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Zip | 98584-3574
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Country | US
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Telephone | 360-349-1488
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Fax |
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Provider Business Mailing Address
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Address Line | 531 SE TOTTEN SHORES DR
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City | SHELTON
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State | WA
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Zip | 98584-8353
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Country | US
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Telephone | 360-432-9217
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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 | LH00005070
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License Number State | WA
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