Provider Demographics
NPI:1760716013
Name:MAYONE, HEATHER (BA,MPS, ATR-BC, LCAT)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:MAYONE
Suffix:
Gender:F
Credentials:BA,MPS, ATR-BC, LCAT
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:MAYONE
Other - Last Name:KIELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA,MPS, ATR-BC, LCAT
Mailing Address - Street 1:20 W 20TH ST STE 804
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-9254
Mailing Address - Country:US
Mailing Address - Phone:646-820-3307
Mailing Address - Fax:
Practice Address - Street 1:20 W 20TH ST STE 804
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-9254
Practice Address - Country:US
Practice Address - Phone:201-616-9288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001243221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist