Basic Information
| Provider Information | |||||||||
| NPI: | 1801209481 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOWALSKI | ||||||||
| FirstName: | HEATHER | ||||||||
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| Credential: | SLP ASSISTANT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 305 NE LOOP 280; BUSINESS TOWER 1, SUITE 200 | ||||||||
| Address2: | |||||||||
| City: | HURST | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177896849 | ||||||||
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| Practice Location | |||||||||
| Address1: | 17480 DALLAS PKWY | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752877337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146235900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2014 | ||||||||
| LastUpdateDate: | 06/11/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2355S0801X | 34064 | TX | Y | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant |
No ID Information.