Basic Information
| Provider Information | |||||||||
| NPI: | 1205141298 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEWART | ||||||||
| FirstName: | HEIDI | ||||||||
| MiddleName: | R | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4330 VILLAGE DR | ||||||||
| Address2: | UNIT C | ||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334452848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613023204 | ||||||||
| FaxNumber: | 5614990071 | ||||||||
| Practice Location | |||||||||
| Address1: | 160 NW 4TH ST | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334323826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613918444 | ||||||||
| FaxNumber: | 5613916823 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2010 | ||||||||
| LastUpdateDate: | 08/14/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SZ4869 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.