Provider Demographics
NPI:1467983171
Name:AARON TODD HEATON PSYCHOLOGIST
Entity Type:Organization
Organization Name:AARON TODD HEATON PSYCHOLOGIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HEATON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:703-304-8464
Mailing Address - Street 1:704 GLENBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21769-7752
Mailing Address - Country:US
Mailing Address - Phone:703-304-8464
Mailing Address - Fax:
Practice Address - Street 1:365 W PATRICK ST
Practice Address - Street 2:SUITE 205
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4854
Practice Address - Country:US
Practice Address - Phone:703-304-8464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04297251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health