Provider Demographics
NPI:1043604242
Name:HEALY, MAEVE
Entity Type:Individual
Prefix:
First Name:MAEVE
Middle Name:
Last Name:HEALY
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 1:300 LANDIS CT APT 304
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-9261
Mailing Address - Country:US
Mailing Address - Phone:305-498-3906
Mailing Address - Fax:
Practice Address - Street 1:300 LANDIS CT APT 304
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-9261
Practice Address - Country:US
Practice Address - Phone:305-498-3906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT 26312255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer