Provider Demographics
NPI:1659648277
Name:CHRISTY, HEATHER DAWN (OT)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:DAWN
Last Name:CHRISTY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:DAWN
Other - Last Name:MATHIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:114 HCR 1436
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76636-4517
Mailing Address - Country:US
Mailing Address - Phone:254-580-3984
Mailing Address - Fax:
Practice Address - Street 1:402 S COLONIAL DR
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-4617
Practice Address - Country:US
Practice Address - Phone:817-645-0785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110708225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist