Basic Information
| Provider Information | |||||||||
| NPI: | 1508003385 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEYN | ||||||||
| FirstName: | DARIA | ||||||||
| MiddleName: | LILLIAN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | O.T.R. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2448 S 102ND ST | ||||||||
| Address2: | SUITE 340 | ||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532272466 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4143292500 | ||||||||
| FaxNumber: | 4143292501 | ||||||||
| Practice Location | |||||||||
| Address1: | 958 FOOTE ST | ||||||||
| Address2: | |||||||||
| City: | SEYMOUR | ||||||||
| State: | WI | ||||||||
| PostalCode: | 541651044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9208337796 | ||||||||
| FaxNumber: | 9208332220 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2009 | ||||||||
| LastUpdateDate: | 01/15/2009 | ||||||||
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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 | 225XG0600X | 7-026 | WI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Gerontology |
No ID Information.