Provider Demographics
NPI:1629382700
Name:HUGHES, HEATHER LYNN (COTA/L)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:HUGHES
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 INDUSTRY RD
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:OH
Mailing Address - Zip Code:44201-9349
Mailing Address - Country:US
Mailing Address - Phone:330-947-2124
Mailing Address - Fax:
Practice Address - Street 1:1464 INDUSTRY RD
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:OH
Practice Address - Zip Code:44201-9349
Practice Address - Country:US
Practice Address - Phone:330-947-2124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA 4415224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant