Basic Information
| Provider Information | |||||||||
| NPI: | 1285713529 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FISHER | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1502 TIMBER TRL | ||||||||
| Address2: | |||||||||
| City: | IMPERIAL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151268906 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 135 CUMBERLAND RD | ||||||||
| Address2: | 105 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152375447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123641886 | ||||||||
| FaxNumber: | 4123647120 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2006 | ||||||||
| LastUpdateDate: | 05/19/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC009180 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 1017604340002 | 05 | PA | MEDICAID | 204151437 | 01 | PA | HEALTH AMERICA-ASPIRE | OTHER | 1553259 | 01 | PA | GATEWAY | OTHER | 1017604340001 | 05 | PA | MEDICAID | 001908551 | 01 | PA | HIGHMARK | OTHER |