Provider Demographics
NPI:1265677892
Name:BOHNE, HEIDI ANNALISA (MS ED CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:ANNALISA
Last Name:BOHNE
Suffix:
Gender:F
Credentials:MS ED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3424 STATE ROUTE 4
Mailing Address - Street 2:
Mailing Address - City:HUDSON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12839-3513
Mailing Address - Country:US
Mailing Address - Phone:518-435-5492
Mailing Address - Fax:
Practice Address - Street 1:3424 STATE ROUTE 4
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839-3513
Practice Address - Country:US
Practice Address - Phone:518-435-5492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013964-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist