Doctor Name: | HEATHER M BACA |
NPI Number: | 1255497327 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.,ED.,CCC-SLP |
License Number: | |
Business Practice Address: | 441 University St Trinidad, CO - 810822542 |
Business Phone Number: | 7198461500 |
Business Fax Number: | 7198461501 |
Mailing Address: | 441 University St, TRINIDAD |
State: | CO |
Postal Code: | 810822542 |
Phone Number: | 7198461500 |
Fax Number: | 7198461501 |
NPI Enumeration Date: | 12/31/2006 |
NPI Last Update Date: | 02/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |