Provider Demographics
NPI:1851303085
Name:WATT, HEATHER MARIE (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:WATT
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6979 S HOLLY CIR
Mailing Address - Street 2:STE 105
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1577
Mailing Address - Country:US
Mailing Address - Phone:303-694-2295
Mailing Address - Fax:303-694-1843
Practice Address - Street 1:6979 S HOLLY CIR STE 105
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1065
Practice Address - Country:US
Practice Address - Phone:303-694-2295
Practice Address - Fax:303-694-1843
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1046488225X00000X
CO1266225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
102255323OtherOWCP FACILITY ID
CO06-6563Medicare Oscar/Certification