MEDICARE: HEATHER J DUCKSWORTH LSW

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
1	104100000X	Social Worker	5851-S	NV

General Provider Information

NPI Number	:	1548605538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER J DUCKSWORTH LSW

Provider Business Mailing Address
First Line	:	3724 GRETCHEN CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-6640
Country	:	US
Telephone Number	:	702-302-6342
Fax Number	:	702-836-0803

Provider Business Practice Location Address
First Line	:	3724 GRETCHEN CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-6640
Country	:	US
Telephone Number	:	702-302-6342
Fax Number	:	702-836-0803

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2013
Last Update Date	:	05/03/2013

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