Provider Demographics
NPI:1487679056
Name:WERMER, HEDY SOPHIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:HEDY
Middle Name:SOPHIA
Last Name:WERMER
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 1:11 FOXGLOVE LN
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3431
Mailing Address - Country:US
Mailing Address - Phone:413-210-5992
Mailing Address - Fax:
Practice Address - Street 1:11 FOXGLOVE LN
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-3431
Practice Address - Country:US
Practice Address - Phone:413-210-5992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2708 PR103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW03400OtherBLUE CROSS/SHIELD ID#
MA2708PROtherSTATE LICENSE