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NPI Code Detail

MEDICARE: HEIDI BORDELON

MEDICARE: HEIDI BORDELON
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 Worker8601LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740713296
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI BORDELON
Provider Business Mailing Address
First Line : 4606 LEE ST
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71302-3235
Country : US
Telephone Number : 318-441-1105
Fax Number : 318-441-2251
Provider Business Practice Location Address
First Line : 4606 LEE ST
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71302-3235
Country : US
Telephone Number : 318-441-1105
Fax Number : 318-441-2251
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2017
Last Update Date : 04/11/2017

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Directions to “ HEIDI BORDELON ” Practice Location

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