Provider Demographics
NPI:1760884779
Name:PANE SEIFERT, HEATHER TORENEE (PHD, MPP)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:TORENEE
Last Name:PANE SEIFERT
Suffix:
Gender:F
Credentials:PHD, MPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 W CHAPEL HILL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3080
Mailing Address - Country:US
Mailing Address - Phone:919-419-3474
Mailing Address - Fax:919-419-9353
Practice Address - Street 1:1121 W CHAPEL HILL ST STE 100
Practice Address - Street 2:#908
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3080
Practice Address - Country:US
Practice Address - Phone:919-419-3474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4547103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist