Provider Demographics
NPI:1013698778
Name:WEMPLE, HEATHER COLEY (TCADC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:COLEY
Last Name:WEMPLE
Suffix:
Gender:F
Credentials:TCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-1220
Mailing Address - Country:US
Mailing Address - Phone:517-395-9997
Mailing Address - Fax:
Practice Address - Street 1:210 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-1220
Practice Address - Country:US
Practice Address - Phone:517-395-9997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY276388101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor