Provider Demographics
NPI:1982094132
Name:BATES, HEATHER (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LOIS
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2981 22ND ST S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-5365
Mailing Address - Country:US
Mailing Address - Phone:505-401-3093
Mailing Address - Fax:
Practice Address - Street 1:2981 22ND ST S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5365
Practice Address - Country:US
Practice Address - Phone:505-401-3093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007610235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist