Provider Demographics
NPI:1932413564
Name:DORAN, HEATHER (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:DORAN
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 1:1670 HIGHWAY 160 W
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8063
Mailing Address - Country:US
Mailing Address - Phone:803-230-8902
Mailing Address - Fax:803-746-4858
Practice Address - Street 1:1670 HIGHWAY 160 W
Practice Address - Street 2:SUITE 201
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-8063
Practice Address - Country:US
Practice Address - Phone:803-230-8902
Practice Address - Fax:803-746-4858
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4163235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist