Provider Demographics
NPI:1518731363
Name:HEFLIN, IKEYIA
Entity Type:Individual
Prefix:
First Name:IKEYIA
Middle Name:
Last Name:HEFLIN
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 1:263 DROOPING LEAF RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-6673
Mailing Address - Country:US
Mailing Address - Phone:803-480-1019
Mailing Address - Fax:
Practice Address - Street 1:263 DROOPING LEAF RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-6673
Practice Address - Country:US
Practice Address - Phone:803-480-1019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician