Provider Demographics
NPI:1477512358
Name:HEINTZ, LINDA D (MS)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:D
Last Name:HEINTZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:ANN
Other - Last Name:DOE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:55 TOBIN RD
Mailing Address - Street 2:
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467
Mailing Address - Country:US
Mailing Address - Phone:585-334-7741
Mailing Address - Fax:
Practice Address - Street 1:40 ALLEN ST
Practice Address - Street 2:BROCKPORT CENTRAL SCHOOL DISTRICT
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420
Practice Address - Country:US
Practice Address - Phone:585-637-1830
Practice Address - Fax:585-637-1835
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00105212255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer