Provider Demographics
NPI:1215723937
Name:SMITH, HEATHER M (CCC-SLP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:SMITH
Suffix:
Gender:
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16102 WALL ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:77040-1268
Mailing Address - Country:US
Mailing Address - Phone:404-422-5977
Mailing Address - Fax:
Practice Address - Street 1:6410 FANNIN ST BLDG WS
Practice Address - Street 2:UTHSC PROFESSIONAL BUILDING, WS# 1100.13
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3000
Practice Address - Country:US
Practice Address - Phone:713-500-7909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111447235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist