Provider Demographics
NPI:1598258048
Name:HINDERMAN, HEIDI MAE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:MAE
Last Name:HINDERMAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:HEIDI
Other - Middle Name:MAE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA/L
Mailing Address - Street 1:7220 WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8556
Mailing Address - Country:US
Mailing Address - Phone:330-350-6967
Mailing Address - Fax:
Practice Address - Street 1:8525 FRIENDSVILLE RD
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:OH
Practice Address - Zip Code:44254-9706
Practice Address - Country:US
Practice Address - Phone:330-948-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-10
Last Update Date:2018-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02895224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant