Provider Demographics
NPI:1780015529
Name:EDWARDS, HEATHER KAY (MS CFY-SLP)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:KAY
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MS CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 W WILL ROGERS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-5421
Mailing Address - Country:US
Mailing Address - Phone:918-341-4343
Mailing Address - Fax:918-341-8687
Practice Address - Street 1:1110 W WILL ROGERS BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-5421
Practice Address - Country:US
Practice Address - Phone:918-341-4343
Practice Address - Fax:918-341-8687
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3515235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist