Provider Demographics
NPI:1235686080
Name:STOCKMAN-ALBRECHT, HEATHER BROOCK (RBT)
Entity Type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:BROOCK
Last Name:STOCKMAN-ALBRECHT
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 VILLAGE SQ STE 210
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1624
Mailing Address - Country:US
Mailing Address - Phone:614-834-1114
Mailing Address - Fax:614-987-8643
Practice Address - Street 1:6355 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-2068
Practice Address - Country:US
Practice Address - Phone:614-834-1114
Practice Address - Fax:614-987-8643
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRBT-17-45921106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician