Provider Demographics
NPI:1043406929
Name:DENING, HEIDI (PT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:DENING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 LISBON ST
Mailing Address - Street 2:UNIT 101
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5063
Mailing Address - Country:US
Mailing Address - Phone:207-376-3000
Mailing Address - Fax:207-376-3003
Practice Address - Street 1:1190 LISBON ST
Practice Address - Street 2:UNIT 101
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5063
Practice Address - Country:US
Practice Address - Phone:207-376-3000
Practice Address - Fax:207-376-3003
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT2655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist