Provider Demographics
NPI:1811519937
Name:HEATER, AUNGELIQUE R (MSW, LISW)
Entity type:Individual
Prefix:
First Name:AUNGELIQUE
Middle Name:R
Last Name:HEATER
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:AUNGELIQUE
Other - Middle Name:R
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW,LSW
Mailing Address - Street 1:526 CLINTON SPRINGS AVE UNIT C
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45217-1955
Mailing Address - Country:US
Mailing Address - Phone:513-349-5504
Mailing Address - Fax:
Practice Address - Street 1:526 CLINTON SPRINGS AVE UNIT C
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45217-1955
Practice Address - Country:US
Practice Address - Phone:513-349-5504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.20021471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical