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Individual

MRS. HEATHER MARIE DEWYZE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS.CF

Contact information

Practice address
500 7TH AVE S, BOX 7700, ST PETERSBURG, FL 33701-4820
(727) 767-6725
Mailing address
835 20TH AVENUE NORTH, ST PETERSBURG, FL 33704
(727) 767-4141

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA9188
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010151600
FL
Enumeration date
02/07/2007
Last updated
06/13/2017
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