Provider Demographics
NPI:1164749479
Name:HEARN, EMILY (ATR-BC, LPC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HEARN
Suffix:
Gender:F
Credentials:ATR-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 EMILY ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-2322
Mailing Address - Country:US
Mailing Address - Phone:267-266-0183
Mailing Address - Fax:
Practice Address - Street 1:9815 ROOSEVELT BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1011
Practice Address - Country:US
Practice Address - Phone:215-342-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005468221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist