Individual
HEIDI LETICIA BRISTOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3200 NORTHLINE AVE STE 160, GREENSBORO, NC 27408-7613
(336) 545-5000
(336) 545-5020
Mailing address
PO BOX 5105, BELFAST, ME 04915-5100
(336) 545-5000
(336) 545-5020
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8430
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8430
OT LICENSE
NC
Enumeration date
12/19/2016
Last updated
01/11/2024
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