Provider Demographics
NPI:1629458310
Name:HEIDE, NORMA (LMT)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:HEIDE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10329 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4380
Mailing Address - Country:US
Mailing Address - Phone:720-443-0601
Mailing Address - Fax:
Practice Address - Street 1:10329 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2003
Practice Address - Country:US
Practice Address - Phone:720-433-0601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT-0001027225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist