Provider Demographics
NPI:1336260041
Name:MCDONALD, HEATHER (BA)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-6861
Mailing Address - Country:US
Mailing Address - Phone:931-766-0332
Mailing Address - Fax:
Practice Address - Street 1:115 DYER ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4551
Practice Address - Country:US
Practice Address - Phone:931-560-4231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health