Provider Demographics
NPI:1205239902
Name:HOLTMAN, HEATHER (EDD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:HOLTMAN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 BROADWAY #4
Mailing Address - Street 2:INSTITUTE FOR CONTEMPORARY PSYCHOTHERAPY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-333-3444
Mailing Address - Fax:
Practice Address - Street 1:1841 BROADWAY #4
Practice Address - Street 2:INSTITUTE FOR CONTEMPORARY PSYCHOTHERAPY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:212-333-3444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017460-1103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling