Provider Demographics
NPI:1316677909
Name:HEUSTON, ROBERT (CRS, BA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:HEUSTON
Suffix:
Gender:M
Credentials:CRS, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-1621
Mailing Address - Country:US
Mailing Address - Phone:814-535-8830
Mailing Address - Fax:
Practice Address - Street 1:132 WALNUT ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-1621
Practice Address - Country:US
Practice Address - Phone:814-535-8830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician