Provider Demographics
NPI:1841440591
Name:KARNES, HEATHER M
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:KARNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:M
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7619 SAN SEBASTIAN WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-7168
Mailing Address - Country:US
Mailing Address - Phone:239-331-0405
Mailing Address - Fax:
Practice Address - Street 1:13721 CYPRESS TERRACE CIR
Practice Address - Street 2:SUITE 702
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-8829
Practice Address - Country:US
Practice Address - Phone:239-482-3154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI 15952355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant