| NPI | 1811359441 |
|---|---|
| Former Name | HEATHER LYNN TYKTOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 093588) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 105566) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2023-09-08 |