Provider Demographics
NPI:1205907144
Name:ADAMS, HEATHER MAE (OTA)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:MAE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12408 HISPERIA RD
Mailing Address - Street 2:
Mailing Address - City:LUSBY
Mailing Address - State:MD
Mailing Address - Zip Code:20657-4563
Mailing Address - Country:US
Mailing Address - Phone:410-326-8111
Mailing Address - Fax:
Practice Address - Street 1:11750 ASBURY CIR
Practice Address - Street 2:
Practice Address - City:SOLOMONS
Practice Address - State:MD
Practice Address - Zip Code:20688-3058
Practice Address - Country:US
Practice Address - Phone:410-394-3066
Practice Address - Fax:410-394-3566
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA01359224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant