Provider Demographics
NPI:1063280451
Name:SPIEGEL, HEATHER ALLEN (MA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ALLEN
Last Name:SPIEGEL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1604
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90308-1604
Mailing Address - Country:US
Mailing Address - Phone:310-951-4345
Mailing Address - Fax:
Practice Address - Street 1:1081 WESTWOOD BLVD STE 234
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-2931
Practice Address - Country:US
Practice Address - Phone:310-951-4345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist