Healthcare Provider Details

I. General information

NPI: 1588502033
Provider Name (Legal Business Name): HEIDI OWEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI FREEMAN

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 UPPER BRUSH CREEK RD
MARSHALL NC
28753-9599
US

IV. Provider business mailing address

265 UPPER BRUSH CREEK RD
MARSHALL NC
28753-9599
US

V. Phone/Fax

Practice location:
  • Phone: 828-697-4733
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30004239
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: