Provider Demographics
NPI:1750774097
Name:MANER, HEATHER ALISON
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ALISON
Last Name:MANER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:ALISON
Other - Last Name:COWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:170 BLACKWELL DR
Mailing Address - Street 2:
Mailing Address - City:HOHENWALD
Mailing Address - State:TN
Mailing Address - Zip Code:38462-2316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 E JAMES CAMPBELL BLVD
Practice Address - Street 2:SUITE 113
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4597
Practice Address - Country:US
Practice Address - Phone:931-490-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator