Provider Demographics
NPI:1366876815
Name:TATTERSALL, HEATHER LEIGH (MS, MPH, OTR/L)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LEIGH
Last Name:TATTERSALL
Suffix:
Gender:F
Credentials:MS, MPH, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 2ND AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4558
Mailing Address - Country:US
Mailing Address - Phone:302-593-9424
Mailing Address - Fax:
Practice Address - Street 1:1355 2ND AVE APT 3A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4558
Practice Address - Country:US
Practice Address - Phone:302-593-9424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-01
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist