Provider Demographics
NPI:1205079050
Name:COLDEBELLA, HEATHER FERGUSON (MS)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:FERGUSON
Last Name:COLDEBELLA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 ALTON PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2207
Mailing Address - Country:US
Mailing Address - Phone:617-519-9060
Mailing Address - Fax:
Practice Address - Street 1:3809 ALTON PL NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2207
Practice Address - Country:US
Practice Address - Phone:617-519-9060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS