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General NPI Number Information
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NPI Number | 1184014383
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Entity Type | Individual
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Provider Name | HEIDI H BURKHART COTA/L
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Gender | Female
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 7550 ASSISI HTS
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-3853
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Country | US
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Telephone | 719-598-5486
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Fax |
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Provider Business Mailing Address
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Address Line | 5510 E 32ND ST # 189
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City | YUMA
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State | AZ
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Zip | 85365-7604
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Country | US
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Telephone | 513-532-8318
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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 | OTA.03511
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License Number State | OH
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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 | OTA.0001434
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License Number State | CO
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