Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | CW018873 | PA |
NPI | 1003274101 |
---|---|
Provider Name | Ms. Heather Alters |
First Address | Philadelphia, PA 19131-2824 |
Second Address | Philadelphia, PA 19131-2824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2016 |
Last Update Date | 03/02/2016 |