Individual
HEATHER DAWN BOURASSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
15875 NEW HALLS FERRY RD, FLORISSANT, MO 63031-1225
(314) 953-5400
Mailing address
2622 GURNEY CT, SAINT LOUIS, MO 63110-3416
(314) 599-4050
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2019045240
MO
Other
Enumeration date
01/11/2020
Last updated
01/11/2020
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