Individual
MADISON HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20531 DARDEN RD, SOUTH BEND, IN 46637-2915
(574) 272-0100
Mailing address
189 WABEENO TRL, MEDFORD LAKES, NJ 08055-1319
(609) 678-5808
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
072.0134420
VT
225X00000X
Occupational Therapist
Primary
31008690A
IN
225X00000X
Occupational Therapist
46TR01141200
NJ
Other
Enumeration date
11/14/2023
Last updated
04/09/2025
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