Individual
MRS. HEATHER A PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
3324 KEENES EDGE DR, COLUMBIA, MO 65201-6660
(573) 442-0925
Mailing address
3324 KEENES EDGE DR, COLUMBIA, MO 65201-6660
(573) 442-0925
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2004036769
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
467221602
—
MO
Enumeration date
11/01/2006
Last updated
07/08/2007
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