Provider Demographics
NPI:1871763243
Name:FLYNN, HEATHER MARIE (COTA/L)
Entity type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:MARIE
Last Name:FLYNN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1574
Mailing Address - Country:US
Mailing Address - Phone:978-774-6955
Mailing Address - Fax:
Practice Address - Street 1:44 SUMMER ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1574
Practice Address - Country:US
Practice Address - Phone:978-774-6955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-02
Last Update Date:2008-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2905224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant