Provider Demographics
NPI:1508003385
Name:HEYN, DARIA LILLIAN (OTR)
Entity Type:Individual
Prefix:MS
First Name:DARIA
Middle Name:LILLIAN
Last Name:HEYN
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 1:2448 S 102ND ST
Mailing Address - Street 2:SUITE 340
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2466
Mailing Address - Country:US
Mailing Address - Phone:414-329-2500
Mailing Address - Fax:414-329-2501
Practice Address - Street 1:958 FOOTE ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:WI
Practice Address - Zip Code:54165-1044
Practice Address - Country:US
Practice Address - Phone:920-833-7796
Practice Address - Fax:920-833-2220
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7-026225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology