Beaudry, Heather L
Beaudry, Heather L is an sole proprietor health care provider with primary practice located at 1907 N Roan St Ste 207 , Johnson City TN 37601-3182. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Beaudry, Heather L can be contacted via phone (423) 282-0164.Contact Information
Primary practice address
1907 N Roan St Ste 207
Johnson City TN 37601-3182
Phone: (423) 282-0164
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | TN2735 | Tennessee |
Profile Details
| NPI number | 1760464937 |
|---|---|
| LBN Legal business name | Beaudry, Heather L |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 15th, 2005 |
| Last updated | Apr 12th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760464937 | NPPES |
| Pennsylvania | Other | 042017 | BLUE SHIELD |
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