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Individual

MS. HEATHER LOUISE GRACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1563 PIEDMONT RD, SOMERSET, PA 15501-4625
(814) 279-4807
Mailing address
1563 PIEDMONT RD, SOMERSET, PA 15501-4625
(814) 279-4807

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC012811
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
225X00000X
PA
Enumeration date
05/12/2016
Last updated
05/12/2016
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