Provider Demographics
NPI:1275792699
Name:VAN HOUTEN, HEATHER (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:VAN HOUTEN
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25727 VELVET ROSE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-2493
Mailing Address - Country:US
Mailing Address - Phone:830-980-1971
Mailing Address - Fax:
Practice Address - Street 1:25727 VELVET ROSE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-2493
Practice Address - Country:US
Practice Address - Phone:830-980-1971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101036235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist