Provider Demographics
NPI:1477866200
Name:HEIMAN, SHARON K (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:K
Last Name:HEIMAN
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 UNDINE RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3812
Mailing Address - Country:US
Mailing Address - Phone:512-934-1958
Mailing Address - Fax:
Practice Address - Street 1:82 UNDINE RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3812
Practice Address - Country:US
Practice Address - Phone:512-934-1958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA648235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist