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Individual

HEATHER ADAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
601 ELMWOOD AVE, BOX 635, ROCHESTER, NY 14642-0001
(585) 275-7787
Mailing address
601 ELMWOOD AVE, BOX 635, ROCHESTER, NY 14642-0001
(585) 275-7787

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
015472
NY
103G00000X
Clinical Neuropsychologist
15472
NY
103TC0700X
Clinical Psychologist
015472
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02493323
NY
01
J400024246
MEDICARE PROVIDER PTAN
NY
Enumeration date
07/25/2006
Last updated
07/05/2023
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