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NPI Code Detail

MEDICARE: HEATHER DENEANE BERSUCH

MEDICARE: HEATHER DENEANE BERSUCH
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
1235Z00000XSpeech-Language Pathologist2000163575MO

General Provider Information

NPI Number : 1154463586
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER DENEANE BERSUCH
Provider Business Mailing Address
First Line : 313 SE GINGERBREAD LN
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64014-3612
Country : US
Telephone Number : 816-229-6228
Fax Number :
Provider Business Practice Location Address
First Line : 2133 NW 13TH ST
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64015-7734
Country : US
Telephone Number : 816-224-0003
Fax Number : 816-224-2199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/08/2007

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Directions to “ HEATHER DENEANE BERSUCH ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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