Healthcare Provider Details

I. General information

NPI: 1073825261
Provider Name (Legal Business Name): MISS HEATHER LYNN ADAMSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2010
Last Update Date: 07/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25615 N RANCH GATE RD
SCOTTSDALE AZ
85255-2141
US

IV. Provider business mailing address

22427 N 22ND WAY
PHOENIX AZ
85024-6514
US

V. Phone/Fax

Practice location:
  • Phone: 480-502-7726
  • Fax: 480-513-4628
Mailing address:
  • Phone: 480-734-5913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA6561
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: