Provider Demographics
NPI:1033340237
Name:NADEAU, HEIDI A (LMT)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:A
Last Name:NADEAU
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 STATE RD
Mailing Address - Street 2:PEPPERELL GREEN OFFICE SUITE 103
Mailing Address - City:KITTERY
Mailing Address - State:ME
Mailing Address - Zip Code:03904-1564
Mailing Address - Country:US
Mailing Address - Phone:207-439-9045
Mailing Address - Fax:207-703-0289
Practice Address - Street 1:74 STATE RD
Practice Address - Street 2:PEPPERELL GREEN OFFICE SUITE 103
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-1564
Practice Address - Country:US
Practice Address - Phone:207-439-9045
Practice Address - Fax:207-703-0289
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT-4133225700000X
AZMT-12566225700000X
NH3353M225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist