Heidi Kathleen Hicinbothom
NPI #1023534252 in Grand Ronde, Oregon
Provider Information
- NPI Number
- 1023534252
- Entity Type
- Individual
- Name
- Heidi Kathleen Hicinbothom
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Enumeration Date
- Aug 18, 2017
- Last Updated
- Dec 2, 2021
Practice Location
- Address
- 9605 GRAND RONDE RD
- City
- Grand Ronde
- State
- Oregon
- ZIP Code
- 97347-9712
- Phone
- (503) 879-2026
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
| Peer Specialist |
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