Provider Demographics
NPI:1154072460
Name:OGLESBEE, HEATHER REANN (LMT)
Entity Type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:REANN
Last Name:OGLESBEE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:REANN
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:981 ASHLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44905
Mailing Address - Country:US
Mailing Address - Phone:419-709-9511
Mailing Address - Fax:419-709-9424
Practice Address - Street 1:981 ASHLAND ROAD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44905
Practice Address - Country:US
Practice Address - Phone:419-709-9511
Practice Address - Fax:419-709-9424
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.015861225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist