Provider Demographics
NPI:1790959153
Name:GIRSCH, HEIDI JANE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:JANE
Last Name:GIRSCH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:HEIDI
Other - Middle Name:JANE
Other - Last Name:COSTIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:6221 W 98TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-1729
Mailing Address - Country:US
Mailing Address - Phone:952-835-5111
Mailing Address - Fax:952-921-3272
Practice Address - Street 1:6221 W 98TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55438-1729
Practice Address - Country:US
Practice Address - Phone:952-835-5111
Practice Address - Fax:952-921-3272
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101680225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist