Individual
HEATHER NICOLE HABERHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5022 OLD GODSEY LN, SUITE 3, HIXSON, TN 37343-6600
(423) 870-3573
(423) 870-3574
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446652
—
TN
01
—
3156797
BCBST - GROUP NUMBER
TN
Enumeration date
05/26/2006
Last updated
01/27/2011
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