Provider Demographics
NPI:1922423805
Name:DR HEIDI H STODDARD & ASSOCIATES
Entity Type:Organization
Organization Name:DR HEIDI H STODDARD & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:H
Authorized Official - Last Name:STODDARD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:972-359-1077
Mailing Address - Street 1:100 ALLENTOWN PKWY
Mailing Address - Street 2:SUITE 114
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-4200
Mailing Address - Country:US
Mailing Address - Phone:972-359-1077
Mailing Address - Fax:972-359-8236
Practice Address - Street 1:100 ALLENTOWN PKWY
Practice Address - Street 2:SUITE 114
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-4200
Practice Address - Country:US
Practice Address - Phone:972-359-1077
Practice Address - Fax:972-359-8236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty