Provider Demographics
NPI:1578278107
Name:OFFUTT, HEATHER (MSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:OFFUTT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 CANTRELL RD APT 309
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-1842
Mailing Address - Country:US
Mailing Address - Phone:863-591-5839
Mailing Address - Fax:
Practice Address - Street 1:3700 CANTRELL RD APT 309
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-1842
Practice Address - Country:US
Practice Address - Phone:863-591-5839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health