Provider Demographics
NPI:1881821114
Name:HECK, MOLLY (SLPA)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:HECK
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3152 TRINITY BAY PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-5343
Mailing Address - Country:US
Mailing Address - Phone:530-205-8995
Mailing Address - Fax:
Practice Address - Street 1:9606 TIERRA GRANDE ST STE 107
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-6501
Practice Address - Country:US
Practice Address - Phone:858-695-9415
Practice Address - Fax:858-695-9412
Is Sole Proprietor?:No
Enumeration Date:2009-06-13
Last Update Date:2009-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9162355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant