Provider Demographics
NPI:1952883548
Name:MCDANIEL, HEATHER (MA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-2266
Mailing Address - Country:US
Mailing Address - Phone:443-480-7777
Mailing Address - Fax:
Practice Address - Street 1:960 4TH ST NW
Practice Address - Street 2:
Practice Address - City:WAUKON
Practice Address - State:IA
Practice Address - Zip Code:52172-1059
Practice Address - Country:US
Practice Address - Phone:563-568-3493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist