Provider Demographics
NPI:1568905057
Name:MCDANIEL, HEATHER PRESTON (MSCCC-SLP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:PRESTON
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 DAWSON AVE
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-3211
Mailing Address - Country:US
Mailing Address - Phone:724-602-3002
Mailing Address - Fax:
Practice Address - Street 1:4401 PENN AVE
Practice Address - Street 2:SPEECH THERAPY DEPARTMENT
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1334
Practice Address - Country:US
Practice Address - Phone:412-692-5325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011230235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASL011230OtherPENNSYLVANIA STATE LICENSE
14039216OtherAMERICAN SPEECH LANGUAGE HEARING ASSOCIATION