Provider Demographics
NPI:1891300695
Name:HEID, CATHLEEN D
Entity Type:Individual
Prefix:MS
First Name:CATHLEEN
Middle Name:D
Last Name:HEID
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 1:400 MOUNT VERNON DR
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-5207
Mailing Address - Country:US
Mailing Address - Phone:469-271-6843
Mailing Address - Fax:
Practice Address - Street 1:400 E STATE ST STE D
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1856
Practice Address - Country:US
Practice Address - Phone:740-249-4514
Practice Address - Fax:800-480-7578
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator