Provider Demographics
NPI:1023499472
Name:PHILLIPS, HEATHER (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 MADISON 8520
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72740-5026
Mailing Address - Country:US
Mailing Address - Phone:479-244-0371
Mailing Address - Fax:
Practice Address - Street 1:4 N DOUBLE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:AR
Practice Address - Zip Code:72730-2522
Practice Address - Country:US
Practice Address - Phone:479-267-5960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist