Provider Demographics
NPI:1174096077
Name:TURNER, HEATHER (MOTR/L)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:MARTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:90 TABLAZON RD
Mailing Address - Street 2:
Mailing Address - City:TIJERAS
Mailing Address - State:NM
Mailing Address - Zip Code:87059-7464
Mailing Address - Country:US
Mailing Address - Phone:505-316-1530
Mailing Address - Fax:
Practice Address - Street 1:2301 YALE BLVD SE STE A3
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4350
Practice Address - Country:US
Practice Address - Phone:505-385-8028
Practice Address - Fax:855-254-6287
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist