Individual
MRS. HEIDI BRUETTING BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. ED., CCC/SLP
Contact information
Practice address
200 PARTIN DR N, NICEVILLE, FL 32578-1244
(850) 420-3693
Mailing address
328 CHIPPEWA DR, NICEVILLE, FL 32578-8244
(850) 897-1509
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4240
FL
Other
Enumeration date
09/20/2009
Last updated
09/20/2009
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