Provider Demographics
NPI:1891090551
Name:MARKWELL, HEATHER NICOLE (BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:NICOLE
Last Name:MARKWELL
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 DEVONSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-1530
Mailing Address - Country:US
Mailing Address - Phone:240-434-6749
Mailing Address - Fax:606-677-0412
Practice Address - Street 1:8800 DEVONSHIRE DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-1530
Practice Address - Country:US
Practice Address - Phone:240-434-6749
Practice Address - Fax:606-677-0412
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0055103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst