Provider Demographics
NPI:1316493646
Name:BALLANTYNE, HEATHER ANNE (MA CFY)
Entity type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:ANNE
Last Name:BALLANTYNE
Suffix:
Gender:F
Credentials:MA CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7331 CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1646
Mailing Address - Country:US
Mailing Address - Phone:712-229-0934
Mailing Address - Fax:
Practice Address - Street 1:6700 ANTIOCH
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204
Practice Address - Country:US
Practice Address - Phone:913-652-9229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist