Provider Demographics
NPI:1295183895
Name:SPICER, HEATHER
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SPICER
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 1:725 N HIGHWAY A1A STE A104
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-4561
Mailing Address - Country:US
Mailing Address - Phone:561-446-0446
Mailing Address - Fax:561-473-9617
Practice Address - Street 1:725 N HIGHWAY A1A STE A104
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-4561
Practice Address - Country:US
Practice Address - Phone:561-446-0446
Practice Address - Fax:561-473-9617
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other