Doctor Name: | HEIDI TAKACS |
NPI Number: | 1013202134 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | |
Business Practice Address: | 1300 N Palafox St Ste 103 Pensacola, FL - 325012664 |
Business Phone Number: | 8502662700 |
Business Fax Number: | |
Mailing Address: | T1300 N Palafox St, Ste 103 PENSACOLA |
State: | FL |
Postal Code: | 325012664 |
Phone Number: | 8502662700 |
Fax Number: | |
NPI Enumeration Date: | 06/16/2011 |
NPI Last Update Date: | 03/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |