Provider Demographics
NPI:1992444764
Name:BREE, HEATHER (MSOM, LAC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BREE
Suffix:
Gender:F
Credentials:MSOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 PATHWAY DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-7713
Mailing Address - Country:US
Mailing Address - Phone:919-665-8908
Mailing Address - Fax:
Practice Address - Street 1:620 W LANE ST STE 103
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1441
Practice Address - Country:US
Practice Address - Phone:919-665-8908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC565171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist