Basic Information
| Provider Information | |||||||||
| NPI: | 1376788877 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HART | ||||||||
| FirstName: | HEATHER | ||||||||
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| Credential: | MA, OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2501 TOP HILL RD | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402062830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5027181512 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4121 SHELBYVILLE RD STE 7 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402073205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028931380 | ||||||||
| FaxNumber: | 5028931773 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2008 | ||||||||
| LastUpdateDate: | 04/09/2019 | ||||||||
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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 | 225XP0200X | 132297 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No ID Information.