Provider Demographics
NPI:1841447232
Name:GRIGG, HEATHER ANN (MOTR/L)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:GRIGG
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ANN
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:6631 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-4355
Mailing Address - Country:US
Mailing Address - Phone:307-268-9904
Mailing Address - Fax:307-268-9907
Practice Address - Street 1:6631 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4355
Practice Address - Country:US
Practice Address - Phone:307-268-9904
Practice Address - Fax:307-268-9907
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOTR 758225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist