Provider Demographics
NPI:1093749392
Name:CRESWICK, HEATHER (MS)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:CRESWICK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 780125
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0125
Mailing Address - Country:US
Mailing Address - Phone:804-922-4844
Mailing Address - Fax:
Practice Address - Street 1:1101 EAST MARSHALL STREET
Practice Address - Street 2:ROOM 11-005
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0033
Practice Address - Country:US
Practice Address - Phone:804-828-6245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0139000013170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS