Provider Demographics
NPI:1467792499
Name:OKVAT, HEATHER A (PHD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:A
Last Name:OKVAT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 S BROADWAY STE 600
Mailing Address - Street 2:AGING MATTERS PSYCHOLOGICAL SERVICES
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34 S BROADWAY
Practice Address - Street 2:SUITE 600
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4400
Practice Address - Country:US
Practice Address - Phone:914-681-9435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019994103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical