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General NPI Number Information
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NPI Number | 1396133567
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Entity Type | Individual
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Provider Name | HEIDI LYNN VANDERMEULEN M.S. ED,, TVI
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Gender | Female
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 12/22/2014
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Provider Practice Location Address
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Address Line | 415 DELAND DRIVE
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City | UTICA
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State | NY
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Zip | 13502
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Country | US
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Telephone | 315-269-7377
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Fax |
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Provider Business Mailing Address
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Address Line | 415 DELAND DR
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City | UTICA
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State | NY
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Zip | 13502-1918
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Country | US
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Telephone | 315-269-7377
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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 | 225500000X
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Taxonomy Name | Respiratory/Developmental/Rehabilitative Specialist/Technologist
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License Number | 1859165
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License Number State | NY
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