Provider Demographics
NPI:1881188977
Name:HEIZER, MEKAYLA JOY (COTA/L)
Entity Type:Individual
Prefix:
First Name:MEKAYLA
Middle Name:JOY
Last Name:HEIZER
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 1:663 PILSON RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24440-1919
Mailing Address - Country:US
Mailing Address - Phone:540-290-7072
Mailing Address - Fax:
Practice Address - Street 1:131 W GRACE ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22807-1039
Practice Address - Country:US
Practice Address - Phone:540-568-4980
Practice Address - Fax:540-568-3886
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant