Provider Demographics
NPI:1477685204
Name:HECK, LAURA ONACKI (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ONACKI
Last Name:HECK
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 QUINN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-9653
Mailing Address - Country:US
Mailing Address - Phone:406-587-4648
Mailing Address - Fax:
Practice Address - Street 1:612 MAIN STREET SUITE C
Practice Address - Street 2:EPICENTER THERAPY SERVICES
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715
Practice Address - Country:US
Practice Address - Phone:407-522-3722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT58225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics