Provider Demographics
NPI:1376196204
Name:ANDERSON, HEATHER NICOLE KAREN (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:NICOLE KAREN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23035 SCHUSSMARK TRL UNIT B
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:CO
Mailing Address - Zip Code:80467-9661
Mailing Address - Country:US
Mailing Address - Phone:919-523-0600
Mailing Address - Fax:
Practice Address - Street 1:23035 SCHUSSMARK TRL UNIT B
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:CO
Practice Address - Zip Code:80467-9661
Practice Address - Country:US
Practice Address - Phone:919-523-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0006065225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics