Healthcare Provider Details

I. General information

NPI: 1952654782
Provider Name (Legal Business Name): HEATHER L PUTNEY LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 PENNSYLVANIA AVE
WEST MIFFLIN PA
15122-3914
US

IV. Provider business mailing address

1817 PENNSYLVANIA AVE
WEST MIFFLIN PA
15122-3914
US

V. Phone/Fax

Practice location:
  • Phone: 412-532-1773
  • Fax: 412-896-5141
Mailing address:
  • Phone: 412-532-1773
  • Fax: 412-896-5141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMF000693
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: