Healthcare Provider Details

I. General information

NPI: 1407573512
Provider Name (Legal Business Name): M. HEATHER MCKAY PHD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 N NASH ST
HILLSBOROUGH NC
27278-2335
US

IV. Provider business mailing address

204 N NASH ST
HILLSBOROUGH NC
27278-2335
US

V. Phone/Fax

Practice location:
  • Phone: 919-260-0139
  • Fax:
Mailing address:
  • Phone: 919-260-0139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number6726
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number6726
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: