Provider Demographics
NPI:1225535545
Name:DEAN-DRUMMOND, HEATHER (MA LP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:DEAN-DRUMMOND
Suffix:
Gender:F
Credentials:MA LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 PARKWAY E
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5719
Mailing Address - Country:US
Mailing Address - Phone:646-734-9624
Mailing Address - Fax:
Practice Address - Street 1:16 W 10TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8707
Practice Address - Country:US
Practice Address - Phone:646-734-9624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001018-1103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis