Provider Demographics
NPI:1306001417
Name:WINDSOR, HEATHER G (OTR/L)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:G
Last Name:WINDSOR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:G
Other - Last Name:HATTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2725 WATER RIDGE PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-4580
Mailing Address - Country:US
Mailing Address - Phone:704-831-5065
Mailing Address - Fax:704-831-5066
Practice Address - Street 1:126 MILLPORT CIR
Practice Address - Street 2:SUITE 201
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5564
Practice Address - Country:US
Practice Address - Phone:864-329-1480
Practice Address - Fax:831-329-8427
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC606225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC606OtherSC LICENSE