Individual
MRS. VALERIE DIANE HEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
122 E 8TH ST, PECATONICA, IL 61063-9205
(815) 988-4438
Mailing address
122 E 8TH ST, PECATONICA, IL 61063-9205
(815) 988-4438
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057001045
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057001045
PROFESSIONAL LICENSE
IL
Enumeration date
06/09/2008
Last updated
06/09/2008
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