Provider Demographics
NPI:1861549313
Name:GAHR, HEIDI LYNN (PSYD)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:LYNN
Last Name:GAHR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1011 N MAYFAIR RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3431
Mailing Address - Country:US
Mailing Address - Phone:414-514-8155
Mailing Address - Fax:414-443-1635
Practice Address - Street 1:1011 N MAYFAIR RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3431
Practice Address - Country:US
Practice Address - Phone:414-514-8155
Practice Address - Fax:414-443-1635
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2842-057103TC0700X
NC4425103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41001700Medicaid
WI1861549313Medicaid