Individual
KRISTEN ELIZABETH HEACOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L, CLWT
Contact information
Practice address
24326 E MAXWELL AVE, LIBERTY LAKE, WA 99019-8633
(509) 218-3443
Mailing address
24326 E MAXWELL AVE, LIBERTY LAKE, WA 99019-8633
(509) 218-3443
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
OT60805745
WA
225X00000X
Occupational Therapist
Primary
OT60805745
WA
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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