Basic Information
| Provider Information | |||||||||
| NPI: | 1376945659 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FIERCE | ||||||||
| FirstName: | HEATHER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3206 BINFORD CT | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284056410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103521398 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1920 S 16TH ST | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284016611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106322191 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2014 | ||||||||
| LastUpdateDate: | 06/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | P016265 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | P009211 | NC | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.