Provider Demographics
NPI:1285347591
Name:MCENTYRE, HEATHER ANN (MA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:MCENTYRE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 122
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79604-0122
Mailing Address - Country:US
Mailing Address - Phone:325-320-9223
Mailing Address - Fax:325-670-5014
Practice Address - Street 1:310 N WILLIS ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79603-6919
Practice Address - Country:US
Practice Address - Phone:325-677-7895
Practice Address - Fax:325-670-5014
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85185101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional