Provider Demographics
NPI:1164097655
Name:WARD, HEATHER CAROLINE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:CAROLINE
Last Name:WARD
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 1:1005 NE LAKE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-4544
Mailing Address - Country:US
Mailing Address - Phone:515-360-8155
Mailing Address - Fax:
Practice Address - Street 1:1005 NE LAKE VIEW DR
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-4544
Practice Address - Country:US
Practice Address - Phone:515-360-8155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA108129235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist