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NPI 1942370325

NPI 1942370325 : JODELLE L HEATH MS OTR : CONCORD, NH

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General NPI Number Information
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    NPI Number           |    1942370325
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    Entity Type          |    Individual 
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    Provider Name        |    JODELLE L HEATH MS OTR
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/09/2006
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    Last Update Date     |    08/29/2007
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Provider Practice Location Address
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    Address Line         |    2 PILLSBURY STREET SUITE 404
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    City                 |    CONCORD
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    State                |    NH
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    Zip                  |    03301-3549
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    Country              |    US
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    Telephone            |    603-228-7827
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    Fax                  |    603-228-7828
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Provider Business Mailing Address
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    Address Line         |    200 PAIGE HILL RD 
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    City                 |    GOFFSTOWN
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    State                |    NH
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    Zip                  |    03045
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    Country              |    US
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    Telephone            |    603-384-1004
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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        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    1712
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    License Number State |    NH
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