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Individual

HEIDI BOHMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCA

Contact information

Practice address
502 FARRELL DR, COVINGTON, KY 41011-3717
(859) 578-3204
(859) 578-3273
Mailing address
502 FARRELL DR, COVINGTON, KY 41011-3717
(859) 578-3204
(859) 578-3273

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
164510
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
610661458
TAX ID
KY
Enumeration date
03/07/2017
Last updated
03/07/2017
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