Provider Demographics
NPI:1659958601
Name:HOLCK, HEATHER (CLC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HOLCK
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W WOODSCHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-7013
Mailing Address - Country:US
Mailing Address - Phone:908-334-3279
Mailing Address - Fax:
Practice Address - Street 1:101 W WOODSCHURCH RD
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-7013
Practice Address - Country:US
Practice Address - Phone:908-334-3279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN