Provider Demographics
NPI:1770900342
Name:CHATMAN, HEATHER L
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:CHATMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:L
Other - Last Name:CHATMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15352 210TH ST
Mailing Address - Street 2:
Mailing Address - City:PURCELL
Mailing Address - State:OK
Mailing Address - Zip Code:73080-4348
Mailing Address - Country:US
Mailing Address - Phone:405-412-3434
Mailing Address - Fax:
Practice Address - Street 1:15352 210TH ST.
Practice Address - Street 2:
Practice Address - City:PURCELL
Practice Address - State:OK
Practice Address - Zip Code:73080-0000
Practice Address - Country:US
Practice Address - Phone:405-412-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst