MEDICARE: HEATHER WIAND MA, BCBA

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1528655222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER WIAND MA, BCBA

Provider Business Mailing Address
First Line	:	13997 AVALON EAST DR
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46037-6211
Country	:	US
Telephone Number	:	317-868-6651
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 FALL HILL AVE STE 105
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22401-3570
Country	:	US
Telephone Number	:	540-899-5790
Fax Number	:	866-499-8840

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

Provider Enumeration Date	:	12/29/2020
Last Update Date	:	07/29/2025

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