Provider Demographics
NPI:1770803710
Name:HERNANDEZ, HEATHER REBMANN (LICSW)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:REBMANN
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ROSE
Other - Last Name:REBMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:165 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-3228
Mailing Address - Country:US
Mailing Address - Phone:781-777-2102
Mailing Address - Fax:
Practice Address - Street 1:165 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-3228
Practice Address - Country:US
Practice Address - Phone:781-777-2102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1153391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical