Provider Demographics
NPI:1043821770
Name:COHEN, HEATHER WHITNEY
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:WHITNEY
Last Name:COHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 STILLBROOK LN
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6460
Mailing Address - Country:US
Mailing Address - Phone:516-473-3276
Mailing Address - Fax:
Practice Address - Street 1:3208 STILLBROOK LN
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6460
Practice Address - Country:US
Practice Address - Phone:516-473-3276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-15
Last Update Date:2020-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst