Provider Demographics
NPI:1558112664
Name:LUDWIG, HEATHER RAE (SLP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RAE
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5241
Mailing Address - Country:US
Mailing Address - Phone:360-788-8143
Mailing Address - Fax:
Practice Address - Street 1:9 MEADOW CT
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-7655
Practice Address - Country:US
Practice Address - Phone:360-920-3645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61331427235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist