Provider Demographics
NPI:1144007634
Name:QUAGLIANA, HEATHER LEWIS (PHD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:LEWIS
Last Name:QUAGLIANA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3954 WILLOW BEND TRL NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-1839
Mailing Address - Country:US
Mailing Address - Phone:626-399-5382
Mailing Address - Fax:
Practice Address - Street 1:1060 PEERLESS XING NW STE 100
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3785
Practice Address - Country:US
Practice Address - Phone:626-399-5382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2898103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist