Provider Demographics
NPI:1255008355
Name:HEIDT, ERIN (RBT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HEIDT
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 1:6849 PEACHTREE DUNWOODY RD BLDG A1
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-6769
Mailing Address - Country:US
Mailing Address - Phone:678-691-2206
Mailing Address - Fax:404-393-3133
Practice Address - Street 1:6849 PEACHTREE DUNWOODY RD BLDG A1
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-6769
Practice Address - Country:US
Practice Address - Phone:708-800-7506
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-21-181987106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician