Provider Demographics
NPI:1720825615
Name:GOODMAN CAVE, HEATHER ALINE (MSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ALINE
Last Name:GOODMAN CAVE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ALINE
Other - Last Name:GOODMANCAVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:805 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7651
Mailing Address - Country:US
Mailing Address - Phone:907-738-9939
Mailing Address - Fax:
Practice Address - Street 1:805 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7651
Practice Address - Country:US
Practice Address - Phone:907-738-9939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker