Individual
MARA HECKATHORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
618A S MAIN ST, REIDSVILLE, NC 27320-5020
(336) 951-6090
Mailing address
618A S MAIN ST, REIDSVILLE, NC 27320-5020
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
14828
NC
Other
Enumeration date
03/16/2022
Last updated
03/16/2022
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