Provider Demographics
NPI:1942633268
Name:MAPLES, HEATHER (LPN, LHMC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:MAPLES
Suffix:
Gender:F
Credentials:LPN, LHMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 S PINE BANKS RD
Mailing Address - Street 2:
Mailing Address - City:PUTNEY
Mailing Address - State:VT
Mailing Address - Zip Code:05346-8792
Mailing Address - Country:US
Mailing Address - Phone:802-258-8205
Mailing Address - Fax:802-523-2623
Practice Address - Street 1:5 BRIDGE ST APT 3
Practice Address - Street 2:
Practice Address - City:SHELBURNE FALLS
Practice Address - State:MA
Practice Address - Zip Code:01370-1123
Practice Address - Country:US
Practice Address - Phone:802-258-8205
Practice Address - Fax:802-523-2623
Is Sole Proprietor?:No
Enumeration Date:2013-08-11
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA10363101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health