Provider Demographics
NPI:1063664803
Name:RUSIEWICZ, HEATHER LEAVY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LEAVY
Last Name:RUSIEWICZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 FISHER HL
Mailing Address - Street 2:600 FORBES AVENUE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15282-0001
Mailing Address - Country:US
Mailing Address - Phone:412-396-4200
Mailing Address - Fax:412-396-1388
Practice Address - Street 1:406 FISHER HL
Practice Address - Street 2:711 FORBES AVENUE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15282-0001
Practice Address - Country:US
Practice Address - Phone:412-396-4200
Practice Address - Fax:412-396-1388
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006406L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA698542OtherHIGHMARK