Doctor Name: | HEIDI S EASTMAN |
NPI Number: | 1336373844 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | CW016135 |
Business Practice Address: | 1 N Main St Coudersport, PA - 169151630 |
Business Phone Number: | 8142748651 |
Business Fax Number: | 8142748652 |
Mailing Address: | 110 Lincoln St, RIDGWAY |
State: | PA |
Postal Code: | 158531939 |
Phone Number: | 8147762145 |
Fax Number: | 8147761470 |
NPI Enumeration Date: | 05/12/2009 |
NPI Last Update Date: | 05/12/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CW016135 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |