Provider Demographics
NPI:1104078013
Name:HEFLIN, TAMI BEEMAN (MS, SSP)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:BEEMAN
Last Name:HEFLIN
Suffix:
Gender:F
Credentials:MS, SSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 BRES AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5915
Mailing Address - Country:US
Mailing Address - Phone:318-323-9484
Mailing Address - Fax:
Practice Address - Street 1:511 BRES AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5915
Practice Address - Country:US
Practice Address - Phone:318-323-9484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2308101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health