MEDICARE: HEATHER GOLDMAN ED.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	103TS0200X	School Psychologist	2969236	OH

General Provider Information

NPI Number	:	1770981235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER GOLDMAN ED.S.

Provider Business Mailing Address
First Line	:	4500 WARRENSVILLE CENTER RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-4134
Country	:	US
Telephone Number	:	216-295-7710
Fax Number	:

Provider Business Practice Location Address
First Line	:	4270 NORTHFIELD RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-2812
Country	:	US
Telephone Number	:	216-336-6646
Fax Number	:

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

Provider Enumeration Date	:	12/16/2014
Last Update Date	:	12/16/2014

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Directions to “ HEATHER GOLDMAN ED.S.” Practice Location

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