Provider Demographics
NPI:1720706559
Name:GERLACH, HEATHER MARIE
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:GERLACH
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:BEHAVIOR FRONTIERS, LLC
Mailing Address - Street 2:7760 FRANCE AVENUE SOUTH, 11TH FLOOR
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55435
Mailing Address - Country:US
Mailing Address - Phone:612-594-8405
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:7760 FRANCE AVE S FL 11
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55435-5930
Practice Address - Country:US
Practice Address - Phone:612-594-8405
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician