Provider Demographics
NPI:1467609313
Name:EXMEYER, HEIDI RENATA (OTR)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:RENATA
Last Name:EXMEYER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6440 MILLROCK DR
Mailing Address - Street 2:SUITE 175
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-5589
Mailing Address - Country:US
Mailing Address - Phone:866-724-8555
Mailing Address - Fax:866-588-1518
Practice Address - Street 1:6440 MILLROCK DR
Practice Address - Street 2:SUITE 175
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-5589
Practice Address - Country:US
Practice Address - Phone:866-724-8555
Practice Address - Fax:866-588-1518
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31001219A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist