Provider Demographics
NPI:1518137900
Name:WHITEHAIR, HEIDI ROULEAU (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:ROULEAU
Last Name:WHITEHAIR
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 1:1 PADDOCK RD
Mailing Address - Street 2:
Mailing Address - City:TYNGSBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01879-2415
Mailing Address - Country:US
Mailing Address - Phone:978-649-5859
Mailing Address - Fax:
Practice Address - Street 1:3 PARK DR
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3511
Practice Address - Country:US
Practice Address - Phone:978-392-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6310225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist