Beaudry, Heather L

Beaudry, Heather L is an sole proprietor health care provider with primary practice located at 1907 N Roan St Ste 207 , Johnson City TN 37601-3182. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Beaudry, Heather L can be contacted via phone (423) 282-0164.

Contact Information

Primary practice address
1907 N Roan St Ste 207 Johnson City TN 37601-3182
Phone: (423) 282-0164
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X TN2735 Tennessee

Profile Details

NPI number 1760464937
LBN Legal business name Beaudry, Heather L
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2005
Last updated Apr 12th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760464937 NPPES
Pennsylvania Other 042017 BLUE SHIELD

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