Individual
CANDICE LEIGH HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS SLP
Contact information
Practice address
1610 E SUNSHINE ST, SPRINGFIELD, MO 65804-1313
(417) 523-7500
Mailing address
5631 S FARM ROAD 135, SPRINGFIELD, MO 65810-1907
(417) 834-0065
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
20177025220
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2017025220
—
MO
Enumeration date
08/03/2017
Last updated
08/03/2017
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