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NPI Code Detail

MEDICARE: MRS. HEATHER WILSON RUFF MCD, CCC-SLP

MEDICARE: MRS. HEATHER WILSON RUFF MCD, 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
1235Z00000XSpeech-Language PathologistSP#1676AR

General Provider Information

NPI Number : 1730225566
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HEATHER WILSON RUFF MCD, CCC-SLP
Provider Business Mailing Address
First Line : 305 ALBANY DR
Second Line :
City : JONESBORO
State : AR
Zip : 72404-9463
Country : US
Telephone Number : 870-931-1697
Fax Number :
Provider Business Practice Location Address
First Line : 806 GLENDALE ST
Second Line :
City : JONESBORO
State : AR
Zip : 72401-4455
Country : US
Telephone Number : 870-933-9528
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. HEATHER WILSON RUFF MCD, CCC-SLP” Practice Location

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