Healthcare Provider Details

I. General information

NPI: 1124859475
Provider Name (Legal Business Name): TAMMY D HEFFINGER M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ACADEMIC CIRCLE
BLUEFIELD VA
24605
US

IV. Provider business mailing address

1 ACADEMIC CIR
BLUEFIELD VA
24605-9220
US

V. Phone/Fax

Practice location:
  • Phone: 276-326-1101
  • Fax:
Mailing address:
  • Phone: 276-326-1101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: