Provider Demographics
NPI:1568701027
Name:HEINZ, ALEIDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALEIDA
Middle Name:
Last Name:HEINZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 JOHNSTON RD STE 121
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4490
Mailing Address - Country:US
Mailing Address - Phone:803-415-1582
Mailing Address - Fax:
Practice Address - Street 1:10801 JOHNSTON RD STE 121
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-4490
Practice Address - Country:US
Practice Address - Phone:803-415-1582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist