MEDICARE: MRS. HEATHER TORGERSON M. S., CCC-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	SLP-2118	ID

General Provider Information

NPI Number	:	1548548076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER TORGERSON M. S., CCC-SLP

Provider Business Mailing Address
First Line	:	768 E 330 S
Second Line	:
City	:	DIETRICH
State	:	ID
Zip	:	83324-5136
Country	:	US
Telephone Number	:	208-544-2418
Fax Number	:

Provider Business Practice Location Address
First Line	:	113 E AVENUE F
Second Line	:
City	:	JEROME
State	:	ID
Zip	:	83338-3132
Country	:	US
Telephone Number	:	208-324-2443
Fax Number	:

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

Provider Enumeration Date	:	08/02/2011
Last Update Date	:	08/02/2011

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Directions to “ MRS. HEATHER TORGERSON M. S., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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