Provider Demographics
NPI:1477787505
Name:LIKE, HEATHER D
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:D
Last Name:LIKE
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 1:123 COURTLAND PL
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-2012
Mailing Address - Country:US
Mailing Address - Phone:618-420-9089
Mailing Address - Fax:618-346-1612
Practice Address - Street 1:123 COURTLAND PL
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-2012
Practice Address - Country:US
Practice Address - Phone:618-420-9089
Practice Address - Fax:618-346-1612
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist