Provider Demographics
NPI:1245958008
Name:STUART, HEATHER O
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:O
Last Name:STUART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4424 FORT CHISWELL RD
Mailing Address - Street 2:
Mailing Address - City:AUSTINVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24312-3617
Mailing Address - Country:US
Mailing Address - Phone:276-699-0160
Mailing Address - Fax:276-699-9650
Practice Address - Street 1:4424 FORT CHISWELL RD
Practice Address - Street 2:
Practice Address - City:AUSTINVILLE
Practice Address - State:VA
Practice Address - Zip Code:24312-3617
Practice Address - Country:US
Practice Address - Phone:276-699-0160
Practice Address - Fax:276-699-9650
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000956235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist