Provider Demographics
NPI:1275798431
Name:BRYANT, HEIDI (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:
Last Name:BRYANT
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 1:15048 US HIGHWAY 75
Mailing Address - Street 2:SUITE 1
Mailing Address - City:VAN ALSTYNE
Mailing Address - State:TX
Mailing Address - Zip Code:75495-3227
Mailing Address - Country:US
Mailing Address - Phone:903-482-0032
Mailing Address - Fax:903-482-0032
Practice Address - Street 1:15048 US HIGHWAY 75
Practice Address - Street 2:SUITE 1
Practice Address - City:VAN ALSTYNE
Practice Address - State:TX
Practice Address - Zip Code:75495-3227
Practice Address - Country:US
Practice Address - Phone:903-482-0032
Practice Address - Fax:903-482-0032
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-26
Last Update Date:2008-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18708235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist