Individual
DR. HEATHER SHAW BONILHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD CCC-SLP
Contact information
Practice address
1601 SAINT JULIAN PL, COLUMBIA, SC 29204-2407
(803) 777-2614
Mailing address
1601 SAINT JULIAN PL, COLUMBIA, SC 29204-2407
(803) 777-2614
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3483
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
426521
—
SC
Enumeration date
09/19/2008
Last updated
09/19/2008
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