Provider Demographics
NPI:1194125021
Name:REDDING, HEATHER MARIE (MT-BC, RBT)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MARIE
Last Name:REDDING
Suffix:
Gender:F
Credentials:MT-BC, RBT
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:MARIE
Other - Last Name:VICENTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:1350 ALUM CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2705
Mailing Address - Country:US
Mailing Address - Phone:614-262-7520
Mailing Address - Fax:
Practice Address - Street 1:1350 ALUM CREEK DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-2705
Practice Address - Country:US
Practice Address - Phone:614-262-7520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-15-05327106S00000X
13275225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
13275OtherCERTIFICATION BOARD FOR MUSIC THERAPISTS
RBT-15-05327OtherBEHAVIOR ANALYST CERTIFICATION BOARD