Provider Demographics
NPI:1154176535
Name:GOTTIER, HEATHER MICHELE (EDM & CAS)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MICHELE
Last Name:GOTTIER
Suffix:
Gender:F
Credentials:EDM & CAS
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:MICHELE
Other - Last Name:PORRIELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 MASSACHUSETTS AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3345
Mailing Address - Country:US
Mailing Address - Phone:888-500-2067
Mailing Address - Fax:617-649-8520
Practice Address - Street 1:700 MASSACHUSETTS AVE FL 3
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3345
Practice Address - Country:US
Practice Address - Phone:888-500-2067
Practice Address - Fax:617-649-8520
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health