MEDICARE: MRS. HEATHER FERGUSON COLDEBELLA M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1205079050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER FERGUSON COLDEBELLA M.S.

Provider Business Mailing Address
First Line	:	3809 ALTON PL NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-2207
Country	:	US
Telephone Number	:	617-519-9060
Fax Number	:

Provider Business Practice Location Address
First Line	:	3809 ALTON PL NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-2207
Country	:	US
Telephone Number	:	617-519-9060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2009
Last Update Date	:	04/09/2009

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Directions to “ MRS. HEATHER FERGUSON COLDEBELLA M.S.” Practice Location

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