Provider Demographics
NPI:1225524192
Name:SMITH, HEATHER ANNETTE (AUD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNETTE
Last Name:SMITH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 E RIVERSIDE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8720
Mailing Address - Country:US
Mailing Address - Phone:435-688-8866
Mailing Address - Fax:435-688-2882
Practice Address - Street 1:617 E RIVERSIDE DR STE 102
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8720
Practice Address - Country:US
Practice Address - Phone:435-688-8866
Practice Address - Fax:435-688-2882
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-2472231H00000X
UT10868287-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist