Provider Demographics
NPI:1619445673
Name:RAPP, HEATHER RENEE
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RENEE
Last Name:RAPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1996 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63143-1309
Mailing Address - Country:US
Mailing Address - Phone:314-882-9454
Mailing Address - Fax:
Practice Address - Street 1:1996 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63143-1309
Practice Address - Country:US
Practice Address - Phone:314-882-9454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant