Provider Demographics
NPI:1740078401
Name:JOLLIFFE, HEATHER BROOKLYN
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:BROOKLYN
Last Name:JOLLIFFE
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 1:1466 MICHIGAN RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-8530
Mailing Address - Country:US
Mailing Address - Phone:317-260-7409
Mailing Address - Fax:
Practice Address - Street 1:700 E STATE ROAD 44
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-7692
Practice Address - Country:US
Practice Address - Phone:317-260-7409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst