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NPI Code Detail

MEDICARE: LINDA MARIE NICHOLE HEFLIN BCBA

MEDICARE: LINDA MARIE NICHOLE HEFLIN 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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1609474709
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA MARIE NICHOLE HEFLIN BCBA
Provider Business Mailing Address
First Line : 5900 WARM SPRINGS RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-4362
Country : US
Telephone Number : 718-215-5311
Fax Number :
Provider Business Practice Location Address
First Line : 2751 WARM SPRINGS RD STE A
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-5327
Country : US
Telephone Number : 907-888-9175
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2020
Last Update Date : 08/31/2023

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