Individual provider Active NPI

Heather Vallance

  • Occupational Therapy Assistant
  • Detroit, MI
National Provider Identifier
1083203509
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5202008640 Issued in MI
Practice address
7800 W Outer Dr Ste 300
Detroit, MI 48235-3458
Phone
(313) 340-4442
NPI assigned
Jan 11, 2021
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5202008640 MI Primary

Addresses

Primary practice location

7800 W Outer Dr Ste 300
Detroit, MI 48235-3458

Mailing address

39026 Pinetree St
Livonia, MI 48150-2483
Phone (734) 673-4363

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Psygenics

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5202008640MIMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1083203509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39026 PINETREE ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502483",
            "telephone_number": "734-673-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 W OUTER DR STE 300",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482353458",
            "telephone_number": "313-340-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLANCE",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MI",
            "license": "5202008640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Psygenics",
            "affiliation": "N",
            "address_1": "7800 W Outer Dr Ste 300",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482353458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.