Doctor Name: | HEIDI JOHNS-FIEDLER |
NPI Number: | 1598164469 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 242.003155 |
Business Practice Address: | 3401 N Perryville Rd Rockford, IL - 611148011 |
Business Phone Number: | 8159712000 |
Business Fax Number: | |
Mailing Address: | 3401 N Perryville Rd, ROCKFORD |
State: | IL |
Postal Code: | 611148011 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/17/2014 |
NPI Last Update Date: | 01/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 242.003155 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |