Provider Demographics
NPI:1932375243
Name:FLEURY, HEIDI M (MSPT, CI)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:M
Last Name:FLEURY
Suffix:
Gender:F
Credentials:MSPT, CI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 MONASTERY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-1515
Mailing Address - Country:US
Mailing Address - Phone:413-478-0564
Mailing Address - Fax:
Practice Address - Street 1:581 POQUONOCK AVE
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-2202
Practice Address - Country:US
Practice Address - Phone:860-688-7211
Practice Address - Fax:860-688-5309
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007734174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist