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General NPI Number Information
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NPI Number | 1639040553
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Entity Type | Individual
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Provider Name | HEATHER FIELDS
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Gender | Female
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 3355 LENOX RD NE STE 1000
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City | ATLANTA
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State | GA
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Zip | 30326-2000
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Country | US
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Telephone | 833-322-3423
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Fax |
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Provider Business Mailing Address
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Address Line | 765 AACHEN AVE NW
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City | PALM BAY
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State | FL
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Zip | 32907-9311
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LBA001282
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License Number State | GA
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