Provider Demographics
NPI:1811068505
Name:JACHE, HEIDI VERENA (MD)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:VERENA
Last Name:JACHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 OHIO UNIVERSITY, HUDSON HEALTH CENTER 3RD FLOOR
Mailing Address - Street 2:OHIO UNIVERSITY COUNSELING AND PYSCHOLOGICAL SERVICES
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2979
Mailing Address - Country:US
Mailing Address - Phone:740-593-1616
Mailing Address - Fax:740-593-0091
Practice Address - Street 1:1 OHIO UNIVERSITY, HUDSON HEALTH CENTER 3RD FLOOR
Practice Address - Street 2:OHIO UNIVERSITY COUNSELING AND PYSCHOLOGICAL SERVICES
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2979
Practice Address - Country:US
Practice Address - Phone:740-593-1616
Practice Address - Fax:740-593-0091
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2014-03-10
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Provider Licenses
StateLicense IDTaxonomies
OH35. 0551352084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA16904Medicare UPIN