Provider Demographics
NPI:1407982572
Name:LOWARY, HEATHER L (COTA)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:L
Last Name:LOWARY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703-4942
Mailing Address - Country:US
Mailing Address - Phone:217-652-1073
Mailing Address - Fax:
Practice Address - Street 1:3206 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-4942
Practice Address - Country:US
Practice Address - Phone:217-652-1073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057.00239224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant