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General NPI Number Information
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NPI Number | 1093371403
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Entity Type | Individual
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Provider Name | HEATHER LYNN KESLER
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Gender | Female
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 05/13/2019
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Provider Practice Location Address
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Address Line | 4877 STATE ROUTE 706
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City | MONTROSE
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State | PA
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Zip | 18801-6939
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Country | US
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Telephone | 570-780-0676
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Fax |
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Provider Business Mailing Address
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Address Line | 4877 STATE ROUTE 706
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City | MONTROSE
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State | PA
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Zip | 18801-6939
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 010044
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OP009581
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License Number State | PA
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