Provider Demographics
NPI:1902685209
Name:MONROE, HEATHER MARIE (SUDPT)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MARIE
Last Name:MONROE
Suffix:
Gender:F
Credentials:SUDPT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:MARIE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SUDPT
Mailing Address - Street 1:P.O. BOX 950
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98807
Mailing Address - Country:US
Mailing Address - Phone:509-662-9673
Mailing Address - Fax:509-662-9441
Practice Address - Street 1:327 OKANOGAN AVENUE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801
Practice Address - Country:US
Practice Address - Phone:509-662-9673
Practice Address - Fax:509-662-9441
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO61315536101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)