Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT00004174 | WA |
NPI | 1003237314 |
---|---|
Provider Name | Rebecca Heid |
First Address | Spokane, WA 99217-9615 |
Second Address | Spokane Valley, WA 99216-2165 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2014 |
Last Update Date | 05/01/2014 |