Provider Demographics
NPI:1306540695
Name:LANDER, HEATHER (MS)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:LANDER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-3100
Mailing Address - Country:US
Mailing Address - Phone:781-424-0883
Mailing Address - Fax:
Practice Address - Street 1:112 PLEASANT ST UNIT 5
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2931
Practice Address - Country:US
Practice Address - Phone:603-429-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health