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General NPI Number Information
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NPI Number | 1932384823
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Entity Type | Individual
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Provider Name | LINDA REYMAN HEIMERDINGER LICSW
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Gender | Female
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 131 FAIRGROUND RD
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City | BRATTLEBORO
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State | VT
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Zip | 05301-6328
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Country | US
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Telephone | 802-451-3721
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Fax |
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Provider Business Mailing Address
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Address Line | 12 SCOTT CIR
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City | SPOFFORD
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State | NH
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Zip | 03462-4631
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Country | US
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Telephone | 603-363-4558
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 089-0001213
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License Number State | VT
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