Provider Demographics
NPI:1043332083
Name:HEGGENSTALLER, DEBBIE (OTR)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:HEGGENSTALLER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7678 HIDDEN VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-6645
Mailing Address - Country:US
Mailing Address - Phone:216-536-6690
Mailing Address - Fax:
Practice Address - Street 1:7678 HIDDEN VALLEY LN
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-6645
Practice Address - Country:US
Practice Address - Phone:216-536-6690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.008778225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist