Healthcare Provider Details

I. General information

NPI: 1316181860
Provider Name (Legal Business Name): MARGARET HEYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 04/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 BEVILLE RD SUITE G
SOUTH DAYTONA FL
32119-1712
US

IV. Provider business mailing address

104 LUCKY LN
HARRINGTON DE
19952-2555
US

V. Phone/Fax

Practice location:
  • Phone: 386-756-4395
  • Fax: 866-426-2811
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberU1-0000951
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: