| Doctor Name: | HEIDI STONEBRAKER |
| NPI Number: | 1992019624 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | LL00001574 |
| Business Practice Address: | 1100 Jackson Ave Raymond, WA - 985773308 |
| Business Phone Number: | 3609422424 |
| Business Fax Number: | 3609425287 |
| Mailing Address: | 1952 E 7000 S, Ste 100 SALT LAKE CITY |
| State: | UT |
| Postal Code: | 841216878 |
| Phone Number: | 8019423311 |
| Fax Number: | 8019425955 |
| NPI Enumeration Date: | 08/05/2010 |
| NPI Last Update Date: | 08/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | LL00001574 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| 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 |