Individual
STEPHEN GARY HEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S. CCC-SLP
Contact information
Practice address
6985 CABRIOLET DR, COLORADO SPRINGS, CO 80923-8797
(719) 660-3579
Mailing address
6985 CABRIOLET DR, COLORADO SPRINGS, CO 80923-8797
(719) 204-5236
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
SA22589
FL
235Z00000X
Speech-Language Pathologist
Primary
SLP.0003284
CO
Other
Enumeration date
08/01/2018
Last updated
06/28/2024
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