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NPI Code Detail

MEDICARE: HEIDI MARLENE CUMMINS LBSW, EIS

MEDICARE: HEIDI MARLENE CUMMINS LBSW, EIS
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
1104100000XSocial Worker32459TX

General Provider Information

NPI Number : 1619089927
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI MARLENE CUMMINS LBSW, EIS
Provider Business Mailing Address
First Line : PO BOX 8266
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76307-8266
Country : US
Telephone Number : 940-696-6212
Fax Number : 940-696-6210
Provider Business Practice Location Address
First Line : 1709 10TH ST
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76301-5010
Country : US
Telephone Number : 940-696-6212
Fax Number : 940-696-6210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 02/10/2017

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Directions to “ HEIDI MARLENE CUMMINS LBSW, EIS” Practice Location

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