Provider Demographics
NPI:1932401940
Name:PACEK, HEATHER LYNNETTE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYNNETTE
Last Name:PACEK
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 1:22 BEACONSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-1303
Mailing Address - Country:US
Mailing Address - Phone:508-864-7975
Mailing Address - Fax:
Practice Address - Street 1:22 BEACONSFIELD RD
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-1303
Practice Address - Country:US
Practice Address - Phone:508-864-7975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8593225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist