Provider Demographics
NPI:1578847877
Name:FISCHETTI, HEATHER JANINE (MS, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:JANINE
Last Name:FISCHETTI
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1937 E 28TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2532
Mailing Address - Country:US
Mailing Address - Phone:347-248-5889
Mailing Address - Fax:
Practice Address - Street 1:1937 E 28TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2532
Practice Address - Country:US
Practice Address - Phone:347-248-5889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020425235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist