Provider Demographics
NPI:1528144169
Name:HEITZ, NADINE R (EDD)
Entity type:Individual
Prefix:DR
First Name:NADINE
Middle Name:R
Last Name:HEITZ
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6539 ANTHONY DR STE A
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-1441
Mailing Address - Country:US
Mailing Address - Phone:585-398-8835
Mailing Address - Fax:
Practice Address - Street 1:6539 ANTHONY DR STE A
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-1441
Practice Address - Country:US
Practice Address - Phone:585-398-8835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015102103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist