| Doctor Name: | PROF. HEATHER ANN KIPPING-REGITANO |
| NPI Number: | 1396704300 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.C.S.W.-R. |
| License Number: | R056766-1 |
| Business Practice Address: | 4284 Fraser Fir Dr Manlius, NY - 131048339 |
| Business Phone Number: | 3154914445 |
| Business Fax Number: | 3156826016 |
| Mailing Address: | 4284 Fraser Fir Dr, MANLIUS |
| State: | NY |
| Postal Code: | 131048339 |
| Phone Number: | 3154914445 |
| Fax Number: | 3156826016 |
| NPI Enumeration Date: | 03/20/2006 |
| NPI Last Update Date: | 11/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | R056766-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |