Individual
MRS. TINA M HEEBSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
9244 29TH AVE, KENOSHA, WI 53143-6602
(262) 694-0080
Mailing address
506 E MAIN ST, WATERFORD, WI 53185-4429
(262) 534-3821
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
786-27
WI
Other
Enumeration date
11/23/2012
Last updated
11/23/2012
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