Provider Demographics
NPI:1295932085
Name:DEAN-FEIOCK, HEATHER ANN (MS, OTR)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:ANN
Last Name:DEAN-FEIOCK
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:ANN
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR
Mailing Address - Street 1:7737 DIXON CT
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-7387
Mailing Address - Country:US
Mailing Address - Phone:317-753-0930
Mailing Address - Fax:317-773-9583
Practice Address - Street 1:7737 DIXON CT.
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-7387
Practice Address - Country:US
Practice Address - Phone:317-753-0930
Practice Address - Fax:317-773-9583
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004349A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200859730Medicaid