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General NPI Number Information
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NPI Number | 1205064680
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Entity Type | Organization
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Legal Business Name | HEATHER MUXWORTHY DNP(S), PMHNP-BC, LLC
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Dates
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Enumeration Date | 06/24/2009
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Last Update Date | 06/25/2009
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Provider Practice Location Address
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Address Line | 3300 MONROE AVE STE 309
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City | ROCHESTER
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State | NY
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Zip | 14618-4615
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Country | US
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Telephone | 585-641-0446
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Fax | 585-641-0447
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Provider Business Mailing Address
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Address Line | 3300 MONROE AVE STE 309
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City | ROCHESTER
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State | NY
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Zip | 14618-4615
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Country | US
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Telephone | 585-641-0446
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Fax | 585-641-0447
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Authorized Official
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Title or Position | PRESIDENT OF COMPANY
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Name | MRS. HEATHER ANN MUXWORTHY
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Credential | DNP(S), PMHNP-BC,
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Telephone | 585-641-0446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | F400539
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License Number State | NY
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