Provider Demographics
NPI:1871197848
Name:HANSON, HEATHER (NTP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:NTP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:YEAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NTP
Mailing Address - Street 1:209 BOBBYS CV
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-1937
Mailing Address - Country:US
Mailing Address - Phone:512-762-4033
Mailing Address - Fax:
Practice Address - Street 1:209 BOBBYS CV
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633-1937
Practice Address - Country:US
Practice Address - Phone:512-762-4033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education