Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 056.004829 | IL |
N | 225XP0200X | Occupational Therapist - Pediatrics | 056.004829 | IL |
NPI | 1811247141 |
---|---|
Provider Name | Mrs. Heidi Dawn Hoskins |
First Address | Belleville, IL 62226 |
Second Address | Belleville, IL 62226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2012 |
Last Update Date | 13/09/2012 |