Provider Demographics
NPI:1568075687
Name:PELOQUIN, HEIDY L (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HEIDY
Middle Name:L
Last Name:PELOQUIN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:HEIDY
Other - Middle Name:
Other - Last Name:BERAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:2102 W SUPERIOR ST
Mailing Address - Street 2:APT 407
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55806
Mailing Address - Country:US
Mailing Address - Phone:516-640-2740
Mailing Address - Fax:
Practice Address - Street 1:2102 W SUPERIOR ST
Practice Address - Street 2:APT 407
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55806
Practice Address - Country:US
Practice Address - Phone:516-640-2740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist