Individual
BRANDON D HEYDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
863 N MAIN STREET EXT STE 200, WALLINGFORD, CT 06492-2434
(203) 265-3280
(203) 741-6569
Mailing address
863 N MAIN STREET EXT STE 200, WALLINGFORD, CT 06492-2434
(203) 265-3280
(203) 741-6569
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
119469
TX
225XH1200X
Hand Occupational Therapist
Primary
6194
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390303101
—
TX
01
—
8KD846
BCBS
TX
Enumeration date
07/24/2015
Last updated
01/21/2025
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