Provider Demographics
NPI:1710418058
Name:HEFFINGTON, TERRI JOYCE (BS, SLP/A)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:JOYCE
Last Name:HEFFINGTON
Suffix:
Gender:F
Credentials:BS, SLP/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 E HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AR
Mailing Address - Zip Code:72949-9850
Mailing Address - Country:US
Mailing Address - Phone:479-518-2002
Mailing Address - Fax:
Practice Address - Street 1:4605 E HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AR
Practice Address - Zip Code:72949-9850
Practice Address - Country:US
Practice Address - Phone:479-518-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR#17-0052355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant