Individual
MRS. AMY ILENE HEATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1507 FORBES AVE, PERU, IN 46970-8703
(765) 469-2736
Mailing address
1507 FORBES AVE, PERU, IN 46970-8703
(765) 469-2736
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001282A
IN
Other
Enumeration date
05/01/2008
Last updated
05/01/2008
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