Provider Demographics
NPI:1013126796
Name:WEINBERGER, HEATHER LEIGH (DSII)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LEIGH
Last Name:WEINBERGER
Suffix:
Gender:F
Credentials:DSII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8616 QUAIL CREEK CT NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1728
Mailing Address - Country:US
Mailing Address - Phone:505-620-6943
Mailing Address - Fax:505-255-9971
Practice Address - Street 1:1111 MENAUL BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1614
Practice Address - Country:US
Practice Address - Phone:505-255-5501
Practice Address - Fax:505-255-9971
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0518171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator