Provider Demographics
NPI:1104008234
Name:HEIMANN, MARTHA M (BS)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:M
Last Name:HEIMANN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BACON RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-2236
Mailing Address - Country:US
Mailing Address - Phone:781-275-2766
Mailing Address - Fax:
Practice Address - Street 1:17 BACON RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-2236
Practice Address - Country:US
Practice Address - Phone:781-275-2766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist