Provider Demographics
NPI:1942425863
Name:STAUFFER, HEATHER (MS, OTR-L)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:STAUFFER
Suffix:
Gender:F
Credentials:MS, OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 HAMILTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-4539
Mailing Address - Country:US
Mailing Address - Phone:610-821-0123
Mailing Address - Fax:610-821-4366
Practice Address - Street 1:3440 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-4539
Practice Address - Country:US
Practice Address - Phone:610-821-0123
Practice Address - Fax:610-821-4366
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP002890L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist