Provider Demographics
NPI:1093112765
Name:MICHAUD, HEATHER CHRISTINE (BS)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:CHRISTINE
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:CHRISTINE
Other - Last Name:COMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 WAYNE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4526
Mailing Address - Country:US
Mailing Address - Phone:931-560-3075
Mailing Address - Fax:931-560-3072
Practice Address - Street 1:211 WAYNE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4526
Practice Address - Country:US
Practice Address - Phone:931-560-3075
Practice Address - Fax:931-560-3072
Is Sole Proprietor?:No
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator