Provider Demographics
NPI:1851470751
Name:RUOFF, HEATHER RAE (SLP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RAE
Last Name:RUOFF
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:R
Other - Last Name:NIEBRUGGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:21200 E 52ND ST CT S
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-2247
Mailing Address - Country:US
Mailing Address - Phone:816-224-3345
Mailing Address - Fax:
Practice Address - Street 1:129 NE PARKS VIEW CT
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2353
Practice Address - Country:US
Practice Address - Phone:816-588-3782
Practice Address - Fax:816-350-7668
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002006277235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO36261011OtherBCBS - OT
MO36261021OtherBCBS - OC