Individual
SANDRA LEE HEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR
Contact information
Practice address
8049 W SANDS DR, PEORIA, AZ 85383-2190
(623) 225-8894
Mailing address
8049 W SANDS DR, PEORIA, AZ 85383-2190
(623) 225-8894
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2112
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
754136
AHCCCS
AZ
Enumeration date
05/03/2007
Last updated
03/13/2020
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