Provider Demographics
NPI:1225179278
Name:HELD, RENEE (OTR L)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:HELD
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 CLUB CENTRE CT
Mailing Address - Street 2:APT 2
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3501
Mailing Address - Country:US
Mailing Address - Phone:314-882-2681
Mailing Address - Fax:
Practice Address - Street 1:103 CLUB CENTRE CT
Practice Address - Street 2:APT 2
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-3501
Practice Address - Country:US
Practice Address - Phone:314-882-2681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist