Healthcare Provider Details

I. General information

NPI: 1902306392
Provider Name (Legal Business Name): MRS. HEATHER MARIE HEPPE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 02/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SANDHILL RD
MASON MI
48854-9425
US

IV. Provider business mailing address

3177 26TH ST
HOPKINS MI
49328-9737
US

V. Phone/Fax

Practice location:
  • Phone: 517-336-6060
  • Fax:
Mailing address:
  • Phone: 616-437-3243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201009534
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: