Provider Demographics
NPI:1760262836
Name:STOLTZFUS, HEIDI ELIZABETH MORRIS (BA, MS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:ELIZABETH MORRIS
Last Name:STOLTZFUS
Suffix:
Gender:F
Credentials:BA, MS, BCBA, LBA
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:ELIZABETH
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, MS
Mailing Address - Street 1:5578 BUENA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:GAP
Mailing Address - State:PA
Mailing Address - Zip Code:17527-9714
Mailing Address - Country:US
Mailing Address - Phone:717-951-4867
Mailing Address - Fax:
Practice Address - Street 1:3040 AVEMORE SQUARE PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-7228
Practice Address - Country:US
Practice Address - Phone:434-220-0089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133003144103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst