Healthcare Provider Details

I. General information

NPI: 1780553412
Provider Name (Legal Business Name): ERIN LAYNE HEFNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 WILLARD CIR
HURRICANE WV
25526-8502
US

IV. Provider business mailing address

138 WILLARD CIR
HURRICANE WV
25526-8502
US

V. Phone/Fax

Practice location:
  • Phone: 304-553-9488
  • Fax:
Mailing address:
  • Phone: 304-553-9488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: