Basic Information
| Provider Information | |||||||||
| NPI: | 1972619971 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PALISIN | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | LISW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7271 CRAIGMERE DR | ||||||||
| Address2: | |||||||||
| City: | MIDDLEBURG HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441305342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4408911539 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7265 OLD OAK BLVD | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441303342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4408168200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2006 | ||||||||
| LastUpdateDate: | 03/20/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | I.0009989 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.