Provider Demographics
NPI:1336309038
Name:MITCHELL, HEATHER JOYCE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:JOYCE
Last Name:MITCHELL
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 1:96 COVE RD
Mailing Address - Street 2:
Mailing Address - City:WINTERPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04496-3817
Mailing Address - Country:US
Mailing Address - Phone:207-223-9081
Mailing Address - Fax:207-223-9081
Practice Address - Street 1:96 COVE RD
Practice Address - Street 2:
Practice Address - City:WINTERPORT
Practice Address - State:ME
Practice Address - Zip Code:04496-3817
Practice Address - Country:US
Practice Address - Phone:207-223-9081
Practice Address - Fax:207-223-9081
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0T549225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist