Provider Demographics
NPI:1629157144
Name:ST. AMANT, HEIDI HUDLOW (PT)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:HUDLOW
Last Name:ST. AMANT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8005 CLAMSHELL AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-7591
Mailing Address - Country:US
Mailing Address - Phone:228-218-8848
Mailing Address - Fax:
Practice Address - Street 1:8005 CLAMSHELL AVE
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-7591
Practice Address - Country:US
Practice Address - Phone:228-218-8848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT3373225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist