Provider Demographics
NPI:1629834106
Name:GERHART, HEATHER
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:GERHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 DAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:EAST EARL
Mailing Address - State:PA
Mailing Address - Zip Code:17519-9275
Mailing Address - Country:US
Mailing Address - Phone:717-808-1313
Mailing Address - Fax:
Practice Address - Street 1:409 N STATE ST
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-2100
Practice Address - Country:US
Practice Address - Phone:717-400-8094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF001594106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist