Provider Demographics
NPI:1497858567
Name:LAING, HEATHER (OT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:LAING
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5377 STEWART DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-7837
Mailing Address - Country:US
Mailing Address - Phone:518-469-8119
Mailing Address - Fax:
Practice Address - Street 1:5377 STEWART DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-7837
Practice Address - Country:US
Practice Address - Phone:518-469-8119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010799-1174400000X
VA0119005390225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA9784Medicare ID - Type Unspecified
VA1497858567Medicare UPIN