Provider Demographics
NPI:1134200678
Name:SCHRECK, HEIDI MARIAN (HS)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:MARIAN
Last Name:SCHRECK
Suffix:
Gender:F
Credentials:HS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 TEMPLE ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-2354
Mailing Address - Country:US
Mailing Address - Phone:206-250-7113
Mailing Address - Fax:727-535-4190
Practice Address - Street 1:COMDT CG-1122 US COAST GUARD
Practice Address - Street 2:2100 2ND ST. SW, SUITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:727-535-1437
Practice Address - Fax:727-535-4190
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other