Provider Demographics
NPI:1902421282
Name:PARKER, HEATHER (BEHAVIOR TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 4TH AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:TN
Mailing Address - Zip Code:38544-0010
Mailing Address - Country:US
Mailing Address - Phone:931-858-8300
Mailing Address - Fax:931-901-1348
Practice Address - Street 1:301 4TH AVE SOUTH
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:TN
Practice Address - Zip Code:38544
Practice Address - Country:US
Practice Address - Phone:931-858-8300
Practice Address - Fax:931-901-1348
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician