Provider Demographics
NPI:1598093080
Name:HEUCHERT, JUVIA P (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUVIA
Middle Name:P
Last Name:HEUCHERT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:JOHANNES
Other - Middle Name:WP
Other - Last Name:HEUCHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:390 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-1243
Mailing Address - Country:US
Mailing Address - Phone:814-337-2037
Mailing Address - Fax:814-337-2060
Practice Address - Street 1:390 PARK AVE
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-1243
Practice Address - Country:US
Practice Address - Phone:814-337-2037
Practice Address - Fax:814-337-2060
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016697103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist