Provider Demographics
NPI:1932403367
Name:ALLESPACH, HEIDI HALLIDAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:HALLIDAY
Last Name:ALLESPACH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 NW 9TH AVE
Mailing Address - Street 2:STE 420
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1101
Mailing Address - Country:US
Mailing Address - Phone:305-243-2872
Mailing Address - Fax:305-243-1251
Practice Address - Street 1:1009 NW 5TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-3212
Practice Address - Country:US
Practice Address - Phone:305-243-2872
Practice Address - Fax:305-243-1251
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5738103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist