Doctor Name: | MRS. HEATHER L PEDERSON |
NPI Number: | 1235346065 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 4778 |
Business Practice Address: | 210 S 6th St Buckeye, AZ - 853262830 |
Business Phone Number: | 6233864487 |
Business Fax Number: | 6233866063 |
Mailing Address: | 18179 W Ocotillo Ave, GOODYEAR |
State: | AZ |
Postal Code: | 853385074 |
Phone Number: | 6023575926 |
Fax Number: | |
NPI Enumeration Date: | 05/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4778 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
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 |