Individual
ANNA HEITHAUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.H.S., CF-SLP
Contact information
Practice address
501 SUNFLOWER LN, O FALLON, MO 63366-1851
(636) 272-2704
Mailing address
501 SUNFLOWER LN, O FALLON, MO 63366-1851
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2016022691
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2016022691
—
MO
Enumeration date
08/23/2016
Last updated
08/23/2016
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