Individual
HEIDI ROSE MCCRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2033 FISHER ARCH, SUITE 120, VIRINGIA BEACH, VA 23456
(757) 395-8485
Mailing address
1404 RAND CT, VIRGINIA BEACH, VA 23464-6461
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119007027
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE
—
VA
Enumeration date
04/29/2020
Last updated
04/29/2020
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