Provider Demographics
NPI:1609330976
Name:PINDER, HEIDI ELIZABETH (COTA)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:ELIZABETH
Last Name:PINDER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4384 BLACK OAK LN
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-8436
Mailing Address - Country:US
Mailing Address - Phone:419-944-4592
Mailing Address - Fax:
Practice Address - Street 1:4900 HENDRICKSON RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-7632
Practice Address - Country:US
Practice Address - Phone:513-605-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3404224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant