Provider Demographics
NPI:1962616250
Name:POWERS, HEATHER (AUD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:LAWRIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:2475 E BROADWAY ST
Mailing Address - Street 2:#2E
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4928
Mailing Address - Country:US
Mailing Address - Phone:406-495-6968
Mailing Address - Fax:406-495-6963
Practice Address - Street 1:2475 E BROADWAY ST
Practice Address - Street 2:#2E
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4928
Practice Address - Country:US
Practice Address - Phone:406-495-6968
Practice Address - Fax:406-495-6963
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000022675237600000X
231HA2400X, 231HA2500X
NY002146-1231H00000X
MT1232231H00000X
MT396237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier