Provider Demographics
NPI:1386265056
Name:YODER, HEATHER JOY (COTA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:JOY
Last Name:YODER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:JOY
Other - Last Name:BAUMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11200 WILLS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LINVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22834-2633
Mailing Address - Country:US
Mailing Address - Phone:540-383-1483
Mailing Address - Fax:
Practice Address - Street 1:1475 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-2433
Practice Address - Country:US
Practice Address - Phone:540-564-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131002355224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant