Individual
MISS HEIDI LYNN TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1035732
OR
225X00000X
Occupational Therapist
4605
NC
Other
Enumeration date
04/29/2008
Last updated
12/29/2020
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