Provider Demographics
NPI:1316145386
Name:HEINRICH, HEATHER ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ANN
Last Name:HEINRICH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 US HIGHWAY 51 BYP W
Mailing Address - Street 2:PMB 599
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-1950
Mailing Address - Country:US
Mailing Address - Phone:731-439-4301
Mailing Address - Fax:731-439-4301
Practice Address - Street 1:1365 FLOWERING DOGWOOD LN STE EANDF
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-2884
Practice Address - Country:US
Practice Address - Phone:731-439-4301
Practice Address - Fax:731-345-4333
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008012103TC0700X
TN3481103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical