Provider Demographics
NPI:1407319742
Name:BRITT, HEATHER DANN (MOTR/L)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DANN
Last Name:BRITT
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:CHRISTINE
Other - Last Name:DANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6132 W BLACKWATER RD
Mailing Address - Street 2:
Mailing Address - City:ZUNI
Mailing Address - State:VA
Mailing Address - Zip Code:23898-3002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5838 HARBOUR VIEW BLVD STE 130
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2698
Practice Address - Country:US
Practice Address - Phone:757-673-5971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119007533225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation