MEDICARE: HEATHER TIPPING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		SC

General Provider Information

NPI Number	:	1093686065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER TIPPING

Provider Business Mailing Address
First Line	:	4318 FLAT BAY CIR
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-8900
Country	:	US
Telephone Number	:	272-208-8977
Fax Number	:

Provider Business Practice Location Address
First Line	:	4318 FLAT BAY CIR
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-8900
Country	:	US
Telephone Number	:	272-208-8977
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	01/17/2026

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Directions to “ HEATHER TIPPING ” Practice Location

Language	Start Address	Practice Location

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