Provider Demographics
NPI:1356771976
Name:NELSON, HEATHER ELIZABETH FJELD (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ELIZABETH FJELD
Last Name:NELSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ELIZABETH
Other - Last Name:FJELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:91 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:VT
Mailing Address - Zip Code:05733-1033
Mailing Address - Country:US
Mailing Address - Phone:802-247-5003
Mailing Address - Fax:
Practice Address - Street 1:263 ELEMENTARY SCHOOL ROAD
Practice Address - Street 2:
Practice Address - City:CASTLETON
Practice Address - State:VT
Practice Address - Zip Code:05735
Practice Address - Country:US
Practice Address - Phone:802-468-5624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist