Individual
DAWN HEIDERSCHEIDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
7421 KEIFFER ST, PHILADELPHIA, PA 19128-1415
(610) 416-3628
Mailing address
7421 KEIFFER ST, PHILADELPHIA, PA 19128-1415
(610) 416-3628
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC013570
PA
Other
Enumeration date
07/27/2020
Last updated
07/27/2020
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