Individual
HEATHER LIDDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
6119 60TH CT SE, LACEY, WA 98513-6472
(360) 972-5123
Mailing address
6119 60TH CT SE, LACEY, WA 98513-6472
(360) 972-5123
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC60562665
WA
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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