Basic Information
| Provider Information | |||||||||
| NPI: | 1659497642 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | LYN | ||||||||
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| Credential: | MA CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26685 LAKE OF THE FALLS BLVD | ||||||||
| Address2: | |||||||||
| City: | OLMSTED FALLS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441382608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3309031115 | ||||||||
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| Practice Location | |||||||||
| Address1: | 255 FRONT ST | ||||||||
| Address2: | |||||||||
| City: | BEREA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440171943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402434000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | COND.2007092-SP | OH | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.