Provider Demographics
NPI:1528603107
Name:RAPOZA, HEATHER
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:RAPOZA
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:PO BOX 5047
Mailing Address - Street 2:
Mailing Address - City:GREENEHAVEN
Mailing Address - State:AZ
Mailing Address - Zip Code:86040-5047
Mailing Address - Country:US
Mailing Address - Phone:734-755-1287
Mailing Address - Fax:
Practice Address - Street 1:462 S LAKE POWELL BLVD
Practice Address - Street 2:
Practice Address - City:PAGE
Practice Address - State:AZ
Practice Address - Zip Code:86040-0856
Practice Address - Country:US
Practice Address - Phone:928-608-4156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant