Provider Demographics
NPI:1952033045
Name:ALCALA DE MOURA, HEATHER JOCELYNE
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:JOCELYNE
Last Name:ALCALA DE MOURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:JOCELYNE
Other - Last Name:ALCALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 AJ GORDON CT APT 110
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-2347
Mailing Address - Country:US
Mailing Address - Phone:781-521-3918
Mailing Address - Fax:
Practice Address - Street 1:35 CONGRESS ST # 225
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-5529
Practice Address - Country:US
Practice Address - Phone:904-758-8637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health