Provider Demographics
NPI:1306197090
Name:CAPE, HEATHER JADE (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:JADE
Last Name:CAPE
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 1:225 HORSESHOE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:KY
Mailing Address - Zip Code:42728-5522
Mailing Address - Country:US
Mailing Address - Phone:606-706-1093
Mailing Address - Fax:
Practice Address - Street 1:225 HORSESHOE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-5522
Practice Address - Country:US
Practice Address - Phone:606-706-1093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4022235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist