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NPI Code Detail

MEDICARE: HEATHER FIDDLER

MEDICARE: HEATHER FIDDLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1699124719
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER FIDDLER
Provider Business Mailing Address
First Line : 6505 SHILOH RD STE 100
Second Line :
City : ALPHARETTA
State : GA
Zip : 30005-1645
Country : US
Telephone Number : 678-648-7644
Fax Number :
Provider Business Practice Location Address
First Line : 2387 HUNTCREST WAY
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30043-8126
Country : US
Telephone Number : 678-648-7644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2016
Last Update Date : 08/08/2023

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Directions to “ HEATHER FIDDLER ” Practice Location

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