Provider Demographics
NPI:1548548076
Name:TORGERSON, HEATHER (M S, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:TORGERSON
Suffix:
Gender:F
Credentials:M S, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:768 E 330 S
Mailing Address - Street 2:
Mailing Address - City:DIETRICH
Mailing Address - State:ID
Mailing Address - Zip Code:83324-5136
Mailing Address - Country:US
Mailing Address - Phone:208-544-2418
Mailing Address - Fax:
Practice Address - Street 1:113 E AVENUE F
Practice Address - Street 2:
Practice Address - City:JEROME
Practice Address - State:ID
Practice Address - Zip Code:83338-3132
Practice Address - Country:US
Practice Address - Phone:208-324-2443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-2118235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist