Provider Demographics
NPI:1609583004
Name:BEHR, HEATHER (PHD, CNS)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:BEHR
Suffix:
Gender:F
Credentials:PHD, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 GURTLER CT APT 3
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6428
Mailing Address - Country:US
Mailing Address - Phone:407-350-1775
Mailing Address - Fax:
Practice Address - Street 1:2133 W FAIRBANKS AVE STE B
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4578
Practice Address - Country:US
Practice Address - Phone:407-350-1775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11692133VN1201X, 133VN1501X, 133NN1002X, 133VN1006X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
No133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic