Provider Demographics
NPI:1912668112
Name:JANVRIN, HEATHER ANN (MS)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:JANVRIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 922
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-0922
Mailing Address - Country:US
Mailing Address - Phone:605-954-2898
Mailing Address - Fax:605-699-8373
Practice Address - Street 1:717 N 5TH ST
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-2048
Practice Address - Country:US
Practice Address - Phone:605-954-2898
Practice Address - Fax:605-699-8373
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health