Basic Information
| Provider Information | |||||||||
| NPI: | 1831505866 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEWMAN | ||||||||
| FirstName: | HEATHER | ||||||||
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| Credential: | M.S. CCC/SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 468 PD SELMAN RD | ||||||||
| Address2: | |||||||||
| City: | LUFKIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 759012160 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3145 DENTON HWY | ||||||||
| Address2: | |||||||||
| City: | HALTOM CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761173710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8178311078 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2014 | ||||||||
| LastUpdateDate: | 01/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 114662 | TX | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 2355S0801X | 37443 | TX | Y | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant |
No ID Information.