Provider Demographics
NPI:1780126201
Name:ARAGON, HEATHER NICOLE (ATC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:NICOLE
Last Name:ARAGON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:NICOLE
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:122 VASSER FARMS DR
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-8444
Mailing Address - Country:US
Mailing Address - Phone:256-777-0232
Mailing Address - Fax:
Practice Address - Street 1:925 FRANKLIN ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4302
Practice Address - Country:US
Practice Address - Phone:256-265-5000
Practice Address - Fax:256-265-7020
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10952255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer