Provider Demographics
NPI:1124859475
Name:HEFFINGER, TAMMY D (MED)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:D
Last Name:HEFFINGER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ACADEMIC CIR
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-9220
Mailing Address - Country:US
Mailing Address - Phone:276-326-1101
Mailing Address - Fax:
Practice Address - Street 1:1 ACADEMIC CIRCLE
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605
Practice Address - Country:US
Practice Address - Phone:276-326-1101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool