Provider Demographics
NPI:1437586518
Name:SANDRY, HEATHER (OTR/L)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SANDRY
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 1:110 GLENNBROOKE LN
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-1956
Mailing Address - Country:US
Mailing Address - Phone:501-231-2406
Mailing Address - Fax:
Practice Address - Street 1:2767 OFFICE PARK CIR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-1143
Practice Address - Country:US
Practice Address - Phone:334-239-9431
Practice Address - Fax:334-239-9415
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3649225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist