Provider Demographics
NPI:1003933730
Name:GUEVARA, HEATHER LYNN (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:GUEVARA
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:DRAHEIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC/SLP
Mailing Address - Street 1:90 BEACH ST
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-2812
Mailing Address - Country:US
Mailing Address - Phone:207-284-4505
Mailing Address - Fax:
Practice Address - Street 1:90 BEACH ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-2812
Practice Address - Country:US
Practice Address - Phone:207-284-4505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1939235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist