Provider Demographics
NPI:1093393357
Name:RESTREPO, HEYLI ELIZABETH
Entity Type:Individual
Prefix:
First Name:HEYLI
Middle Name:ELIZABETH
Last Name:RESTREPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3460 14TH ST NW APT 18
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3492
Mailing Address - Country:US
Mailing Address - Phone:347-606-5979
Mailing Address - Fax:
Practice Address - Street 1:5009 WHISPER WILLOW DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-8205
Practice Address - Country:US
Practice Address - Phone:703-543-4693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202009878235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist