Provider Demographics
NPI:1851944995
Name:HEIM, HOGAN ROBERT (BCBA)
Entity type:Individual
Prefix:
First Name:HOGAN
Middle Name:ROBERT
Last Name:HEIM
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 AMES DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-1704
Mailing Address - Country:US
Mailing Address - Phone:678-994-7889
Mailing Address - Fax:
Practice Address - Street 1:4125 AMES DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-1704
Practice Address - Country:US
Practice Address - Phone:678-994-7889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-24-77743103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst