MEDICARE: HEATHER GADDIS SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	142671	KY

General Provider Information

NPI Number	:	1083543797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER GADDIS SLP

Provider Business Mailing Address
First Line	:	78 SUMMERTREE DR
Second Line	:
City	:	NICHOLASVILLE
State	:	KY
Zip	:	40356-9714
Country	:	US
Telephone Number	:	859-553-6474
Fax Number	:	859-901-0015

Provider Business Practice Location Address
First Line	:	78 SUMMERTREE DR
Second Line	:
City	:	NICHOLASVILLE
State	:	KY
Zip	:	40356-9714
Country	:	US
Telephone Number	:	859-553-6474
Fax Number	:	859-901-0015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “ HEATHER GADDIS SLP” Practice Location

Language	Start Address	Practice Location

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