Provider Demographics
NPI:1669622601
Name:COLAIZZO, HEIDI ANNE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:ANNE
Last Name:COLAIZZO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WOODFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12538-1918
Mailing Address - Country:US
Mailing Address - Phone:845-229-1776
Mailing Address - Fax:
Practice Address - Street 1:232 BLOOMER RD
Practice Address - Street 2:
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540-6229
Practice Address - Country:US
Practice Address - Phone:845-227-3240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009025-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist