HEIDI HICINBOTHOM
Peer Specialist
Active
Individual
NPI: 1023534252
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Counselor - Addiction (Substance Use Disorder) | 101YA0400X | No | T-21-874 (OR) |
| Peer Specialist | 175T00000X | Yes | THW000001683 (OR) |
Frequently Asked Questions
NPI 1023534252 is the National Provider Identifier for HEIDI HICINBOTHOM, a Peer Specialist provider located in Grand Ronde, OR. This NPI was enumerated on August 18, 2017.
HEIDI HICINBOTHOM practices at 9605 GRAND RONDE RD, Grand Ronde, OR 97347.
Quick Facts
- NPI
- 1023534252
- Type
- Individual
- Enumerated
- Aug 18, 2017
- Last Updated
- Dec 2, 2021
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