Individual
HEATHER DAWN MOENING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1800 PENN ST STE 12, MELBOURNE, FL 32901-2625
(321) 768-6800
(321) 768-6858
Mailing address
2264 W NEW HAVEN AVE, MELBOURNE, FL 32904-3874
(321) 759-8208
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10227
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10227
OCCT THERAPIST ASSIST
FL
Enumeration date
09/07/2006
Last updated
07/08/2007
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