Doctor Name: | MRS. HEATHER L. ROGERS |
NPI Number: | 1063564334 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 12075292 |
Business Practice Address: | 1110 Call Creek Dr Ste 7 Pocatello, ID - 832013072 |
Business Phone Number: | 2082334660 |
Business Fax Number: | 2082334262 |
Mailing Address: | 1165 Encino St, POCATELLO |
State: | ID |
Postal Code: | 832012865 |
Phone Number: | 2082382675 |
Fax Number: | |
NPI Enumeration Date: | 01/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12075292 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
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 |