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NPI Code Detail

MEDICARE: MS. HEATHER ANN DIBIASO OTR

MEDICARE: MS. HEATHER ANN DIBIASO OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist002612CT

General Provider Information

NPI Number : 1114146222
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HEATHER ANN DIBIASO OTR
Provider Business Mailing Address
First Line : 26 FERNWOOD DR
Second Line :
City : WINDSOR LOCKS
State : CT
Zip : 06096-1408
Country : US
Telephone Number : 860-614-1487
Fax Number :
Provider Business Practice Location Address
First Line : 1715 ELLINGTON RD
Second Line :
City : SOUTH WINDSOR
State : CT
Zip : 06074-2707
Country : US
Telephone Number : 860-644-4408
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2007
Last Update Date : 11/27/2024

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Directions to “ MS. HEATHER ANN DIBIASO OTR” Practice Location

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