Provider Demographics
NPI:1447897160
Name:DOWELL, HEATHER J
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:J
Last Name:DOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5984 LARAMIE TRL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-4544
Mailing Address - Country:US
Mailing Address - Phone:812-374-8088
Mailing Address - Fax:
Practice Address - Street 1:5984 LARAMIE TRL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-4544
Practice Address - Country:US
Practice Address - Phone:812-374-8088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-01
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1447897160Medicaid
IN300037893Medicaid