Provider Demographics
NPI:1508357971
Name:GERLACH, HEATHER LAURENE
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LAURENE
Last Name:GERLACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 ASSISI DR NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-1637
Mailing Address - Country:US
Mailing Address - Phone:507-218-3460
Mailing Address - Fax:
Practice Address - Street 1:1542 ASSISI DR NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2777
Practice Address - Country:US
Practice Address - Phone:507-218-3460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-22
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional