Provider Demographics
NPI:1033305883
Name:DUPUIS, HEATHER R (OT)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:R
Last Name:DUPUIS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:R
Other - Last Name:PROPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:38935 ANN ARBOR RD STE 150
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3397
Mailing Address - Country:US
Mailing Address - Phone:616-745-0656
Mailing Address - Fax:
Practice Address - Street 1:38935 ANN ARBOR RD STE 150
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-3397
Practice Address - Country:US
Practice Address - Phone:248-886-9540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201009940225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist