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General NPI Number Information
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NPI Number | 1972540235
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Entity Type | Individual
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Provider Name | HEATHER LYNN JAY-BOARDMAN L.S.W.
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Gender | Female
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | 960 CENTURY DR
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City | MECHANICSBURG
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State | PA
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Zip | 17055-4374
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Country | US
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Telephone | 717-795-0330
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Fax | 717-795-0407
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Provider Business Mailing Address
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Address Line | 614 SAINT PAUL ST
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City | LEWISBURG
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State | PA
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Zip | 17837-1349
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Country | US
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Telephone | 570-522-9021
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Fax | 570-524-9492
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW-124655
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License Number State | PA
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