Provider Demographics
NPI:1780977918
Name:HEWITT, HEATHER (MS CFY-SLP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HEWITT
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 1:1720 S CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2129
Mailing Address - Country:US
Mailing Address - Phone:605-334-5630
Mailing Address - Fax:605-332-5327
Practice Address - Street 1:315 OXFORD ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-1601
Practice Address - Country:US
Practice Address - Phone:605-372-2232
Practice Address - Fax:605-372-7326
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8730235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist