Provider Demographics
NPI:1700334570
Name:HECK, BRENDA W
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:W
Last Name:HECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 W 410 N
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:UT
Mailing Address - Zip Code:84737-3150
Mailing Address - Country:US
Mailing Address - Phone:435-979-5227
Mailing Address - Fax:435-634-8700
Practice Address - Street 1:2619 W 410 N
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-3150
Practice Address - Country:US
Practice Address - Phone:435-979-5227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
UT10539021-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical