Provider Demographics
NPI:1558135897
Name:STRADER, HEATHER PRIDE (RMHCI)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:PRIDE
Last Name:STRADER
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12043 COLONY AVE
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2310
Mailing Address - Country:US
Mailing Address - Phone:561-420-9887
Mailing Address - Fax:
Practice Address - Street 1:2560 RCA BLVD STE 115
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3337
Practice Address - Country:US
Practice Address - Phone:561-578-3647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH24290101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health