Provider Demographics
NPI:1477315455
Name:HEIZER, ADAM J
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:J
Last Name:HEIZER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10730 VENETIAN WAY
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-8312
Mailing Address - Country:US
Mailing Address - Phone:937-509-3682
Mailing Address - Fax:
Practice Address - Street 1:218 E NORTH ST
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-1148
Practice Address - Country:US
Practice Address - Phone:937-393-4562
Practice Address - Fax:937-764-1137
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)