Provider Demographics
NPI:1780446039
Name:BURNS, HEATHER D (BS, BHT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:D
Last Name:BURNS
Suffix:
Gender:F
Credentials:BS, BHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 S COUNTRY CLUB DR APT 1147
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-2391
Mailing Address - Country:US
Mailing Address - Phone:504-413-7362
Mailing Address - Fax:
Practice Address - Street 1:355 N ALMA SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:480-641-1165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional