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General NPI Number Information
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NPI Number | 1184084915
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Entity Type | Individual
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Provider Name | HEATHER PLEICKHARDT PHD
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Gender | Female
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Dates
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Enumeration Date | 03/07/2016
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 112 NEWLAKE DR
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-5472
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Country | US
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Telephone | 516-473-8009
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Fax |
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Provider Business Mailing Address
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Address Line | 112 NEWLAKE DR
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-5472
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Country | US
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Telephone | 516-473-8009
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 021352
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY9693
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License Number State | FL
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