Provider Demographics
NPI:1114753464
Name:SPATH, HEATHER (SLP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SPATH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5155 ELLERY TER
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-8357
Mailing Address - Country:US
Mailing Address - Phone:518-944-0544
Mailing Address - Fax:
Practice Address - Street 1:5155 ELLERY TER
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-8357
Practice Address - Country:US
Practice Address - Phone:518-944-0544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist