Provider Demographics
NPI:1174031397
Name:LANTZ, HEATHER RENE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:RENE
Last Name:LANTZ
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 1:45 N WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-2020
Mailing Address - Country:US
Mailing Address - Phone:540-908-5577
Mailing Address - Fax:
Practice Address - Street 1:7979 US HIGHWAY 340
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:VA
Practice Address - Zip Code:22849-3549
Practice Address - Country:US
Practice Address - Phone:540-652-8544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist