Provider Demographics
NPI:1225740749
Name:HEIDELBERG, ABBY M
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:M
Last Name:HEIDELBERG
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 1:118 PANTHER TRL
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-9207
Mailing Address - Country:US
Mailing Address - Phone:501-827-5779
Mailing Address - Fax:
Practice Address - Street 1:2800 S 2ND ST STE B
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-7030
Practice Address - Country:US
Practice Address - Phone:501-286-6175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty