Provider Demographics
NPI:1700449071
Name:ACKART, HEATHER NACOLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:NACOLE
Last Name:ACKART
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 CASA GRANDE BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-2555
Mailing Address - Country:US
Mailing Address - Phone:970-402-3560
Mailing Address - Fax:
Practice Address - Street 1:2850 MCCLELLAND DR STE 3000J
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5206
Practice Address - Country:US
Practice Address - Phone:970-493-6667
Practice Address - Fax:719-931-5559
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOT-1415225X00000X
COOT.0005820225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist