Provider Demographics
NPI:1740441666
Name:HEINITZ, CHERINA S (OTR)
Entity type:Individual
Prefix:
First Name:CHERINA
Middle Name:S
Last Name:HEINITZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 486
Mailing Address - Street 2:28350 CR 317 UNIT 10
Mailing Address - City:BUENA VISTA
Mailing Address - State:CO
Mailing Address - Zip Code:81211-0486
Mailing Address - Country:US
Mailing Address - Phone:719-395-8711
Mailing Address - Fax:
Practice Address - Street 1:28350 COUNTY ROAD 317
Practice Address - Street 2:UNIT 10
Practice Address - City:BUENA VISTA
Practice Address - State:CO
Practice Address - Zip Code:81211-9228
Practice Address - Country:US
Practice Address - Phone:719-395-8711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CON/A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist