Provider Demographics
NPI:1417074097
Name:HEITE, LOUISE B (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:B
Last Name:HEITE
Suffix:
Gender:F
Credentials:MA 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:PO BOX 1199
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-1199
Mailing Address - Country:US
Mailing Address - Phone:907-227-1813
Mailing Address - Fax:
Practice Address - Street 1:43335 KALIFORNSKY BEACH RD
Practice Address - Street 2:BUILDING D, SUITE 16D
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669
Practice Address - Country:US
Practice Address - Phone:907-227-1813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK120235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist