Provider Demographics
NPI:1972881779
Name:DEAN, HEATHER SUZANNE (AUD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:SUZANNE
Last Name:DEAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 NW ELLISON ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-4739
Mailing Address - Country:US
Mailing Address - Phone:817-764-3077
Mailing Address - Fax:817-754-1923
Practice Address - Street 1:121 NW ELLISON ST STE 101
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028
Practice Address - Country:US
Practice Address - Phone:817-405-9469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003875231H00000X
TX80644231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist