Provider Demographics
NPI:1144427410
Name:BRAINARD, HEATHER MICHELE (OT)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MICHELE
Last Name:BRAINARD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 STRATON DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1199
Mailing Address - Country:US
Mailing Address - Phone:740-362-9078
Mailing Address - Fax:
Practice Address - Street 1:2270 WARRENSBURG RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1336
Practice Address - Country:US
Practice Address - Phone:740-369-9614
Practice Address - Fax:740-363-5881
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT- 6480225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist