Provider Demographics
NPI:1295257186
Name:CORWIN, HEIDI ANN (COTA)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANN
Last Name:CORWIN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9109 SNOWY EGRET CT
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-3659
Mailing Address - Country:US
Mailing Address - Phone:540-538-9882
Mailing Address - Fax:
Practice Address - Street 1:60 BRIMLEY DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22406-5148
Practice Address - Country:US
Practice Address - Phone:540-479-3788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant