Individual
MS. REBECCA K. HEAZLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2400 47TH AVE S, GRAND FORKS, ND 58201-3405
(701) 746-2230
Mailing address
18 VAIL CIR, GRAND FORKS, ND 58201-5165
(701) 746-2031
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
428
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58725
—
ND
Enumeration date
01/17/2007
Last updated
07/08/2007
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