Provider Demographics
NPI:1689957367
Name:PARMELEE GRANIERI, HEATHER LYNN (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYNN
Last Name:PARMELEE GRANIERI
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:LYNN
Other - Last Name:GRANIERI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPTA
Mailing Address - Street 1:37 MARYLAND AVE
Mailing Address - Street 2:UNIT 233
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2437
Mailing Address - Country:US
Mailing Address - Phone:301-873-7284
Mailing Address - Fax:
Practice Address - Street 1:37 MARYLAND AVE
Practice Address - Street 2:#233
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:301-873-7284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA3683225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant