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General NPI Number Information
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NPI Number | 1699088823
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Entity Type | Individual
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Provider Name | JENNIFER HEILSHORN MOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/16/2010
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 11570 E 126TH ST
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City | FISHERS
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State | IN
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Zip | 46037-9592
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Country | US
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Telephone | 317-579-0166
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Fax |
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Provider Business Mailing Address
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Address Line | 7957 S DATURA ST
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City | LITTLETON
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State | CO
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Zip | 80120-4439
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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 | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | 0004354
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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