Provider Demographics
NPI:1336436450
Name:HIGGINS-MUNRO, HEATHER L (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:L
Last Name:HIGGINS-MUNRO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:L
Other - Last Name:MUNRO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:466 LONE ELK RD
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-8625
Mailing Address - Country:US
Mailing Address - Phone:605-641-0042
Mailing Address - Fax:
Practice Address - Street 1:466 LONE ELK RD
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-8625
Practice Address - Country:US
Practice Address - Phone:605-641-0042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-10
Last Update Date:2011-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0206225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist