Provider Demographics
NPI:1548960990
Name:HEATH, HARRIET E
Entity type:Individual
Prefix:DR
First Name:HARRIET
Middle Name:E
Last Name:HEATH
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:PO BOX 315
Mailing Address - Street 2:
Mailing Address - City:WINTER HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04693-0315
Mailing Address - Country:US
Mailing Address - Phone:413-230-6568
Mailing Address - Fax:
Practice Address - Street 1:316 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINTER HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04693-0315
Practice Address - Country:US
Practice Address - Phone:413-230-6568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003784L103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily