Provider Demographics
NPI:1316688948
Name:MAYER, HEATHER A (OTR/L)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:MAYER
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 1:200 BUCK RUN RD
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-4241
Mailing Address - Country:US
Mailing Address - Phone:215-470-1479
Mailing Address - Fax:
Practice Address - Street 1:55 S MEADOWOOD DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-6755
Practice Address - Country:US
Practice Address - Phone:302-454-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018309225X00000X
DEU1-0012377225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist