Provider Demographics
NPI:1982145421
Name:HERITAGE, HANNAH (OTR/L)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:HERITAGE
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 1:411 LINCOLN DR W
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-3807
Mailing Address - Country:US
Mailing Address - Phone:215-840-7875
Mailing Address - Fax:
Practice Address - Street 1:411 LINCOLN DR W
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-3807
Practice Address - Country:US
Practice Address - Phone:215-840-7875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC014787405300000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No405300000XOther Service ProvidersPrevention Professional