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General NPI Number Information
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NPI Number | 1245907310
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Entity Type | Individual
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Provider Name | HEATHER NADEAU MOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 55 FOTCH ST
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City | STRATFORD
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State | CT
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Zip | 06615-6811
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Country | US
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Telephone | 800-906-5088
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 STATE ST APT 151
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City | NEW HAVEN
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State | CT
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Zip | 06511-2763
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Country | US
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Telephone | 774-271-2146
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 5981
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License Number State | CT
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