Provider Demographics
NPI:1467932764
Name:HEBERT, CIARA
Entity Type:Individual
Prefix:
First Name:CIARA
Middle Name:
Last Name:HEBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 HADDONFIELD RD STE 120
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-4813
Mailing Address - Country:US
Mailing Address - Phone:856-566-6200
Mailing Address - Fax:856-779-7879
Practice Address - Street 1:57 HADDONFIELD RD STE 120
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-4813
Practice Address - Country:US
Practice Address - Phone:856-566-6200
Practice Address - Fax:856-779-7879
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06335800171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator