Provider Demographics
NPI:1780338574
Name:WILKEY, HEATHER NICOLLE (OTR/L)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:NICOLLE
Last Name:WILKEY
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 1:108 WYCKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-3915
Mailing Address - Country:US
Mailing Address - Phone:912-508-1911
Mailing Address - Fax:
Practice Address - Street 1:108 WYCKFIELD RD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-3915
Practice Address - Country:US
Practice Address - Phone:912-508-1911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT008343225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist