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General NPI Number Information
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NPI Number | 1447737697
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Entity Type | Individual
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Provider Name | HEATHER NICOLE VANSAU MS, CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/20/2018
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Last Update Date | 07/20/2018
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Provider Practice Location Address
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Address Line | 1272 STILLWOOD DR NE
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City | ATLANTA
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State | GA
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Zip | 30306
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Country | US
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Telephone | 254-424-3491
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Fax |
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Provider Business Mailing Address
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Address Line | 5320 PRAIRIE CHAPEL RD
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City | CRAWFORD
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State | TX
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Zip | 76638-3368
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Country | US
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Telephone | 254-424-3491
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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