Provider Demographics
NPI:1861816977
Name:HALASZ, HEATHER
Entity Type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:
Last Name:HALASZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4221 WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-1855
Mailing Address - Country:US
Mailing Address - Phone:419-671-3600
Mailing Address - Fax:
Practice Address - Street 1:4221 WALKER AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-1855
Practice Address - Country:US
Practice Address - Phone:419-671-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20861770103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool