Provider Demographics
NPI:1801178470
Name:TRONSTAD, HEIDI R (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:R
Last Name:TRONSTAD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11541 N MANDARIN LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-9729
Mailing Address - Country:US
Mailing Address - Phone:520-575-1090
Mailing Address - Fax:
Practice Address - Street 1:11541 N MANDARIN LN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85737-9729
Practice Address - Country:US
Practice Address - Phone:520-575-1090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP7210235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist