Provider Demographics
NPI:1861580458
Name:WOODWORTH, HEIDI L (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:L
Last Name:WOODWORTH
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-1756
Mailing Address - Country:US
Mailing Address - Phone:517-278-3384
Mailing Address - Fax:517-279-4946
Practice Address - Street 1:60 LANE 880 SNOW LK
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:IN
Practice Address - Zip Code:46737-9037
Practice Address - Country:US
Practice Address - Phone:260-668-6232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist