Provider Demographics
NPI:1558768630
Name:CORWIN, HEATHER KATHLEEN (EDS)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:KATHLEEN
Last Name:CORWIN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:KATHLEEN
Other - Last Name:HOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDS
Mailing Address - Street 1:105 WASHINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:ST. BERNARD
Mailing Address - State:OH
Mailing Address - Zip Code:45217
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 MAPLE STREET
Practice Address - Street 2:
Practice Address - City:ELMWOOD PLACE
Practice Address - State:OH
Practice Address - Zip Code:45216
Practice Address - Country:US
Practice Address - Phone:513-482-7115
Practice Address - Fax:513-641-5502
Is Sole Proprietor?:No
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist