Provider Demographics
NPI:1134875347
Name:WADSWORTH, HEATHER (SLP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:WADSWORTH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 HETRICK ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2309
Mailing Address - Country:US
Mailing Address - Phone:509-378-8192
Mailing Address - Fax:
Practice Address - Street 1:1200 N 14TH AVE STE 295
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-4195
Practice Address - Country:US
Practice Address - Phone:509-619-7397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL613635669235Z00000X
WA61158376235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist