Provider Demographics
NPI:1730387671
Name:BURTON, HESTER CHARLOTTE (OT)
Entity type:Individual
Prefix:MRS
First Name:HESTER
Middle Name:CHARLOTTE
Last Name:BURTON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:H
Other - Middle Name:CHARLOTTE
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:96555 ALDER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-8190
Mailing Address - Country:US
Mailing Address - Phone:541-469-0540
Mailing Address - Fax:
Practice Address - Street 1:96555 ALDER RIDGE RD
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415-8190
Practice Address - Country:US
Practice Address - Phone:541-469-0540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR986365225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist