Individual
MRS. ASHLEE BURGESS HEINTZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
204 WESLEY ST, CLEMSON, SC 29631-2627
(864) 634-4459
Mailing address
204 WESLEY STREET, CLEMSON, SC 29631
(864) 634-4459
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2707
SC
Other
Enumeration date
04/22/2013
Last updated
04/22/2013
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