Provider Demographics
NPI:1093694275
Name:MARSH, HEIDI ANN
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANN
Last Name:MARSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 RED WING WAY
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-9125
Mailing Address - Country:US
Mailing Address - Phone:609-910-8751
Mailing Address - Fax:609-910-8751
Practice Address - Street 1:2007 RED WING WAY
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-9125
Practice Address - Country:US
Practice Address - Phone:609-910-8751
Practice Address - Fax:609-910-8751
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty