Provider Demographics
NPI:1740560630
Name:ADAMS, HEIDI MARIE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:MARIE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 VO TECH RD
Mailing Address - Street 2:APT. 2
Mailing Address - City:EOLIA
Mailing Address - State:MO
Mailing Address - Zip Code:63344-1096
Mailing Address - Country:US
Mailing Address - Phone:636-295-6864
Mailing Address - Fax:
Practice Address - Street 1:151 VO TECH RD
Practice Address - Street 2:APT. 2
Practice Address - City:EOLIA
Practice Address - State:MO
Practice Address - Zip Code:63344-1096
Practice Address - Country:US
Practice Address - Phone:636-295-6864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009011810235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist