Heather Lee Pelletier, COTA

Individual provider Active NPI Specialist · Johnston, RI

NPI 1619008836 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1619008836
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
OTA00218 (RI)
Practice address
10 Memorial Ave
Johnston, RI 02919-3222
Phone
(401) 233-1900
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OTA00218RIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Johnston Public Schools Past Accepting new patients
Johnston Public Schools Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OTA00218 RI Yes

Addresses

Primary practice location

10 Memorial Ave
Johnston, RI 02919-3222

Mailing address

112 Torrington Dr
Warwick, RI 02889
Phone (401) 737-9090

Other names

  • Heather Lee Vale Other name

Other providers in Johnston, RI

All providers in Johnston, RI · Specialist in Rhode Island

Sources for this page

Verify at the official NPI Registry.