Provider Demographics
NPI:1609170703
Name:HEITS, BLYTHE LEAH (MOTR/L)
Entity Type:Individual
Prefix:MRS
First Name:BLYTHE
Middle Name:LEAH
Last Name:HEITS
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7422 N MANCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64158-1220
Mailing Address - Country:US
Mailing Address - Phone:816-863-3728
Mailing Address - Fax:
Practice Address - Street 1:7422 N MANCHESTER AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-1220
Practice Address - Country:US
Practice Address - Phone:816-863-3728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005001683225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist