Provider Demographics
NPI:1699088658
Name:HEERING, PAUL
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:HEERING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 EULITA TER
Mailing Address - Street 2:#3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22 EULITA TER
Practice Address - Street 2:#3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3353
Practice Address - Country:US
Practice Address - Phone:203-788-3090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst