Provider Demographics
NPI:1538609615
Name:STEMPIN, HEATHER (LICENSED PSYCHOLOGIS)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:STEMPIN
Suffix:
Gender:F
Credentials:LICENSED PSYCHOLOGIS
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:PRYSLOPSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:165 CHARLES STREET
Mailing Address - Street 2:
Mailing Address - City:PAINTED POST
Mailing Address - State:NY
Mailing Address - Zip Code:14870
Mailing Address - Country:US
Mailing Address - Phone:607-936-3704
Mailing Address - Fax:
Practice Address - Street 1:165 CHARLES STREET
Practice Address - Street 2:
Practice Address - City:PAINTED POST
Practice Address - State:NY
Practice Address - Zip Code:14870
Practice Address - Country:US
Practice Address - Phone:607-936-3704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool