Heidi Vanguilder
Individual provider Active NPI Occupational Therapy Assistant · Embarrass, MN
NPI 1962829648 · NPPES record last updated Mar 19, 2014
Key facts
- NPI
- 1962829648
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 200763 (MN)
- Practice address
- 7955 Waris Rd
Embarrass, MN 55732-8034 - Phone
- (218) 391-4900
- NPI assigned
- Mar 19, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200763 | MN | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 200763 | MN | Yes |
Addresses
Primary practice location
7955 Waris Rd
Embarrass, MN 55732-8034
Mailing address
7955 Waris Rd
Embarrass, MN 55732-8034
Phone (218) 391-4900
Other providers in Embarrass, MN
All providers in Embarrass, MN · Occupational Therapy Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.