Provider Demographics
NPI:1295527414
Name:DERIJKE, HEATHER (BCBA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:DERIJKE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 240
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60566-0240
Mailing Address - Country:US
Mailing Address - Phone:314-820-0723
Mailing Address - Fax:314-463-4937
Practice Address - Street 1:3500 S GESSNER RD STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5284
Practice Address - Country:US
Practice Address - Phone:314-820-0723
Practice Address - Fax:314-463-4937
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-24-73423103K00000X
TX8464103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst