Provider Demographics
NPI:1558650309
Name:HESKETT, BARBARA JOYCE (CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JOYCE
Last Name:HESKETT
Suffix:
Gender:F
Credentials:CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 BELLEFORTE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1625
Mailing Address - Country:US
Mailing Address - Phone:708-218-4021
Mailing Address - Fax:
Practice Address - Street 1:615 BELLEFORTE AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1625
Practice Address - Country:US
Practice Address - Phone:708-218-4021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.008302235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist