Provider Demographics
NPI:1558131243
Name:HASKELL, HEIDI ANNE (OT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANNE
Last Name:HASKELL
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 1:10315 PROFESSIONAL CIR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5861
Mailing Address - Country:US
Mailing Address - Phone:775-982-5860
Mailing Address - Fax:
Practice Address - Street 1:10315 PROFESSIONAL CIR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5861
Practice Address - Country:US
Practice Address - Phone:775-982-5860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0045225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation