Provider Demographics
NPI:1538287214
Name:HARTMAN, HEATHER LEE (OT)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LEE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:LEE
Other - Last Name:BRADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:10007 N 103RD EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-7263
Mailing Address - Country:US
Mailing Address - Phone:918-274-1699
Mailing Address - Fax:
Practice Address - Street 1:10007 N 103RD EAST AVE
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-7263
Practice Address - Country:US
Practice Address - Phone:918-274-1699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1447225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist