Provider Demographics
NPI:1184131617
Name:MANCINI, HEATHER MARIE (LAC)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:MARIE
Last Name:MANCINI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 DURHAM RD STE 9
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-9618
Mailing Address - Country:US
Mailing Address - Phone:610-850-2257
Mailing Address - Fax:856-494-1924
Practice Address - Street 1:650 DURHAM RD STE 9
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-9618
Practice Address - Country:US
Practice Address - Phone:610-850-2257
Practice Address - Fax:856-494-1924
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-05
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001248171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist