Individual
SAMANTHA HEAVNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8000
Mailing address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
018807
NY
225X00000X
Occupational Therapist
Primary
—
MI
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
11/17/2014
Last updated
08/17/2023
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