Provider Demographics
NPI:1134353709
Name:GREW, HEATHER MARIE
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MARIE
Last Name:GREW
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 1:80 FERRY BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-6079
Mailing Address - Country:US
Mailing Address - Phone:203-478-1654
Mailing Address - Fax:
Practice Address - Street 1:80 FERRY BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-6079
Practice Address - Country:US
Practice Address - Phone:203-378-1654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker