Individual
HEATHER L TIMBERLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA.166792
Contact information
Practice address
117 N 4TH ST, IRONTON, OH 45638-1403
(740) 237-4981
(877) 325-2816
Mailing address
117 N 4TH ST, IRONTON, OH 45638-1403
(740) 237-4981
(877) 325-2816
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
162394
OH
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276758
—
OH
Enumeration date
01/11/2018
Last updated
08/15/2023
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