Provider Information for 1417331133
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HEATHER ALLEN LCSW
Sex: Female
NPI: 1417331133
Last Updated: 2024-05-17
Certification Date: 2024-05-17
Certification Date: 2024-05-17
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1417331133 | ||||||||
| Enumeration Date | 2015-07-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 161 MAIN ST APT 2 SARANAC LAKE, NY 12983-1747 United States Phone: 518-536-1369 | Fax: | ||||||||
| Primary Practice Address | 70 EDGEWOOD RD SARANAC LAKE, NY 12983-1537 United States Phone: 518-891-8160 | Fax:518-481-8161 | ||||||||
| Secondary Practice Address(es) | 100 PARK ST 7513 COURT ST | ||||||||
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