Individual
MS. HEIDI MICHELE HACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
200 S WALNUT, WESTVILLE, IL 61883-1680
(217) 267-2154
(217) 267-3484
Mailing address
200 S WALNUT, WESTVILLE, IL 61883-1680
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146008156
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146008156
—
IL
Enumeration date
11/15/2017
Last updated
11/15/2017
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