Provider Demographics
NPI:1043433832
Name:NOLAN, DEBORAH HEINBAUGH (PT)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:HEINBAUGH
Last Name:NOLAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ROLLINSON RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-1517
Mailing Address - Country:US
Mailing Address - Phone:508-852-0683
Mailing Address - Fax:
Practice Address - Street 1:119 PROVIDENCE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-4429
Practice Address - Country:US
Practice Address - Phone:508-860-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2088174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist