Provider Demographics
NPI:1285009456
Name:POWERS, HEATHER LYNN
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYNN
Last Name:POWERS
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 1:500 JIMMY ANN DR
Mailing Address - Street 2:APT. 825
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-1391
Mailing Address - Country:US
Mailing Address - Phone:301-338-3290
Mailing Address - Fax:
Practice Address - Street 1:259 BILL FRANCE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-1316
Practice Address - Country:US
Practice Address - Phone:386-206-8071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health