Healthcare Provider Details

I. General information

NPI: 1275687303
Provider Name (Legal Business Name): TAMARA R HECKEL M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 GLADE RUN DR
ZELIENOPLE PA
16063-2200
US

IV. Provider business mailing address

175 N WASHINGTON ST
EAU CLAIRE PA
16030-9817
US

V. Phone/Fax

Practice location:
  • Phone: 724-452-4453
  • Fax:
Mailing address:
  • Phone: 319-321-5666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: