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General NPI Number Information
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NPI Number | 1649593955
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Entity Type | Individual
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Provider Name | MRS. LINDA HEFLIN
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Gender | Female
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Dates
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Enumeration Date | 03/02/2010
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Last Update Date | 03/02/2010
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Provider Practice Location Address
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Address Line | 543 ASHMOOR AVE
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City | BOWLING GREEN
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State | KY
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Zip | 42101-3702
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Country | US
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Telephone | 270-796-4062
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Fax | 270-796-4062
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Provider Business Mailing Address
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Address Line | 543 ASHMOOR AVE
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City | BOWLING GREEN
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State | KY
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Zip | 42101-3702
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Country | US
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Telephone | 270-796-4062
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Fax | 270-796-4062
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number | F19527M
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License Number State | KY
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