Provider Demographics
NPI:1033345152
Name:HESTON, SUSAN FOX (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:FOX
Last Name:HESTON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:CAROL
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:417 E TRIPP RD STE 222
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-9544
Mailing Address - Country:US
Mailing Address - Phone:972-226-5974
Mailing Address - Fax:214-350-3439
Practice Address - Street 1:417 E TRIPP RD
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-9544
Practice Address - Country:US
Practice Address - Phone:972-226-5974
Practice Address - Fax:214-350-3439
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104909235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist