Healthcare Provider Details

I. General information

NPI: 1053084194
Provider Name (Legal Business Name): HEATHER NOFFSINGER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 LOFTIS BLVD STE 103
NEWPORT NEWS VA
23606-2999
US

IV. Provider business mailing address

4 EAGLES LNDG
HAMPTON VA
23669-1661
US

V. Phone/Fax

Practice location:
  • Phone: 434-987-4520
  • Fax:
Mailing address:
  • Phone: 434-987-4520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119010163
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number3164
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: