Provider Demographics
NPI:1619197357
Name:CLOUTMAN, HEATHER MICHELE (MSPT CSCS)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MICHELE
Last Name:CLOUTMAN
Suffix:
Gender:F
Credentials:MSPT CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:29 LIVINGSTON AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-2838
Mailing Address - Country:US
Mailing Address - Phone:914-478-6344
Mailing Address - Fax:
Practice Address - Street 1:8 N AQUEDUCT LN
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NY
Practice Address - Zip Code:10533-1735
Practice Address - Country:US
Practice Address - Phone:914-591-4441
Practice Address - Fax:914-591-4355
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0236531225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist