Doctor Name: | MS. ELIZA LOUISE HEAVENRICH |
NPI Number: | 1023304136 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 13499 |
Business Practice Address: | 805 State St Apt 2 Hood River, OR - 970311801 |
Business Phone Number: | 5032981009 |
Business Fax Number: | |
Mailing Address: | 4560 Se International Way Ste 100, MILWAUKIE |
State: | OR |
Postal Code: | 972224628 |
Phone Number: | 9712065200 |
Fax Number: | |
NPI Enumeration Date: | 06/27/2011 |
NPI Last Update Date: | 01/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 13499 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |