Basic Information
Provider Information
NPI: 1629353636
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DARLING
FirstName: HEIDI
MiddleName: MARIE
NamePrefix: MRS.
NameSuffix:  
Credential: CEP, RCEP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1925 SNYDER DR
Address2:  
City: RICHLAND CENTER
State: WI
PostalCode: 535811026
CountryCode: US
TelephoneNumber: 6086475358
FaxNumber: 6086477929
Practice Location
Address1: 333 E 2ND ST
Address2:  
City: RICHLAND CENTER
State: WI
PostalCode: 535811914
CountryCode: US
TelephoneNumber: 6086476321
FaxNumber: 6086477929
Other Information
ProviderEnumerationDate: 10/21/2011
LastUpdateDate: 10/21/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
224Y00000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist 

No ID Information.


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