Individual
HEATHER J MASK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW, LICSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
06212
IA
1041C0700X
Clinical Social Worker
26748
MN
1041C0700X
Clinical Social Worker
Primary
9988-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
11/15/2006
Last updated
08/08/2022
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