Provider Demographics
NPI:1518492883
Name:HEGGINS, ANGELA DENISE
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DENISE
Last Name:HEGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:DENISE
Other - Last Name:CULLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1545 W MOCKINGBIRD LN STE 4000
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-5014
Mailing Address - Country:US
Mailing Address - Phone:214-821-6505
Mailing Address - Fax:
Practice Address - Street 1:1545 W MOCKINGBIRD LN STE 4000
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-5014
Practice Address - Country:US
Practice Address - Phone:214-821-6505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health