Healthcare Provider Details

I. General information

NPI: 1265157184
Provider Name (Legal Business Name): HEATHER MARIE URANG OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2022
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 PASEO VERDE PKWY STE 155
HENDERSON NV
89074-7121
US

IV. Provider business mailing address

11425 BERMUDA RD UNIT 2078
HENDERSON NV
89052-8726
US

V. Phone/Fax

Practice location:
  • Phone: 702-515-4009
  • Fax:
Mailing address:
  • Phone: 763-234-6164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT-3099
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: