Individual
TAYLOR NICOLE HEITMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3151 STONY ST, MOHEGAN LAKE, NY 10547-1913
(914) 885-1995
Mailing address
3151 STONY ST, MOHEGAN LAKE, NY 10547-1913
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
MA
225XP0200X
Pediatric Occupational Therapist
Primary
025271
NY
Other
Enumeration date
06/18/2018
Last updated
01/31/2022
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