Provider Demographics
NPI:1811264815
Name:CAMPBELL, HEATHER A (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:CAMPBELL
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 1:512 PALMER RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061
Mailing Address - Country:US
Mailing Address - Phone:518-857-7300
Mailing Address - Fax:
Practice Address - Street 1:10 EMPIRE STATE BLVD
Practice Address - Street 2:
Practice Address - City:CASTLETON
Practice Address - State:NY
Practice Address - Zip Code:12033-9751
Practice Address - Country:US
Practice Address - Phone:518-477-8771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-19
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist