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NPI Code Detail

MEDICARE: MS. SUZANN P. HERON

MEDICARE: MS. SUZANN P. HERON
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
1101YM0800XMental Health Counselor4597MA

General Provider Information

NPI Number : 1053332551
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUZANN P. HERON
Provider Business Mailing Address
First Line : 16 SUMNER MOUNTAIN RD
Second Line :
City : AMHERST
State : MA
Zip : 01002-9529
Country : US
Telephone Number : 413-374-1433
Fax Number :
Provider Business Practice Location Address
First Line : 131 W MAIN ST
Second Line :
City : ORANGE
State : MA
Zip : 01364-1150
Country : US
Telephone Number : 413-374-1433
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 07/08/2007

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Directions to “ MS. SUZANN P. HERON ” Practice Location

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