Provider Demographics
NPI:1942268594
Name:RICHARDSON, HEIDI J (OT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:J
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2447
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35403-2447
Mailing Address - Country:US
Mailing Address - Phone:205-345-0192
Mailing Address - Fax:205-464-4507
Practice Address - Street 1:400 PAUL W BRYANT DR E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2009
Practice Address - Country:US
Practice Address - Phone:205-345-2627
Practice Address - Fax:205-247-2878
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT1103225XH1200X
AL4723225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand