Provider Demographics
NPI:1033289640
Name:MORAN, HEATHER R (OT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:MORAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:R
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:18 SIMON STREET
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03061
Mailing Address - Country:US
Mailing Address - Phone:603-883-8205
Mailing Address - Fax:603-881-7198
Practice Address - Street 1:144 CANAL STREET
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064
Practice Address - Country:US
Practice Address - Phone:603-882-6333
Practice Address - Fax:603-889-5460
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1288225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH99560056Medicaid