Provider Demographics
NPI:1952947129
Name:HOISINGTON, HEIDI JO (OTD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:JO
Last Name:HOISINGTON
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:JO
Other - Last Name:WILLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD
Mailing Address - Street 1:1601 14TH ST SE
Mailing Address - Street 2:12
Mailing Address - City:ORANGE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51041
Mailing Address - Country:US
Mailing Address - Phone:605-988-4343
Mailing Address - Fax:
Practice Address - Street 1:1007 7TH ST NE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1190
Practice Address - Country:US
Practice Address - Phone:712-737-8932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA096937225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist