Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT2196 | FL |
NPI | 1063624476 |
---|---|
Provider Name | Ms. Heidi Elaine Spirazza |
First Address | Loxahatchee, FL 33470-4901 |
Second Address | Loxahatchee, FL 33470-4901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2007 |
Last Update Date | 09/07/2007 |