Provider Demographics
NPI:1194464073
Name:HEINRICH, ALISON
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:HEINRICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N AUGUSTA ST STE A
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-3298
Mailing Address - Country:US
Mailing Address - Phone:540-476-2030
Mailing Address - Fax:
Practice Address - Street 1:1011 N AUGUSTA ST STE A
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-3298
Practice Address - Country:US
Practice Address - Phone:540-476-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1236000682225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist