Provider Demographics
NPI:1376261586
Name:HELLER, NINA ANN (MA, OTR/L)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:ANN
Last Name:HELLER
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15961 LOCH KATRINE TRL APT 7101
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-3149
Mailing Address - Country:US
Mailing Address - Phone:561-542-5089
Mailing Address - Fax:
Practice Address - Street 1:15961 LOCH KATRINE TRL APT 7101
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3149
Practice Address - Country:US
Practice Address - Phone:561-542-5089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12534225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty