Provider Demographics
NPI:1801045000
Name:HECK, JENICE D (LOTR)
Entity Type:Individual
Prefix:
First Name:JENICE
Middle Name:D
Last Name:HECK
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 STATE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5733
Mailing Address - Country:US
Mailing Address - Phone:504-899-4501
Mailing Address - Fax:504-895-4162
Practice Address - Street 1:123 STATE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5733
Practice Address - Country:US
Practice Address - Phone:504-899-4501
Practice Address - Fax:504-895-4162
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ12251225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist