Provider Demographics
NPI:1972978344
Name:HEATH, ELIZABETH JULIANNA (MS OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:JULIANNA
Last Name:HEATH
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-6404
Mailing Address - Country:US
Mailing Address - Phone:207-782-2726
Mailing Address - Fax:207-792-1734
Practice Address - Street 1:415 RODMAN RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-3942
Practice Address - Country:US
Practice Address - Phone:207-376-3022
Practice Address - Fax:207-376-3039
Is Sole Proprietor?:No
Enumeration Date:2015-12-10
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT3103225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist