Provider Demographics
NPI:1851159792
Name:HECKER-RICH, SUSAN AMELIA (BSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:AMELIA
Last Name:HECKER-RICH
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 WISCONSIN ST
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-1824
Mailing Address - Country:US
Mailing Address - Phone:319-290-1066
Mailing Address - Fax:
Practice Address - Street 1:6601 HUDSON RD
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-6428
Practice Address - Country:US
Practice Address - Phone:319-290-1066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker