Provider Demographics
NPI:1093341943
Name:HAIN, HEATHER S (PHD, MS, CGC)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:S
Last Name:HAIN
Suffix:
Gender:F
Credentials:PHD, MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 HENRY RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20851-2219
Mailing Address - Country:US
Mailing Address - Phone:267-980-4273
Mailing Address - Fax:
Practice Address - Street 1:7125 13TH PL NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2351
Practice Address - Country:US
Practice Address - Phone:202-545-2510
Practice Address - Fax:202-545-2543
Is Sole Proprietor?:No
Enumeration Date:2020-03-22
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAGC000555170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS
Provider Identifiers
StateIdentifier IDID TypeIssuer
18834OtherAMERICAN BOARD OF GENETIC COUNSELING
PAGC000555OtherPA DEPARTMENT OF STATE, BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS