Individual
MARISUE HEFFNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC SLP
Contact information
Practice address
518 GENTILLY RD, STATESBORO, GA 30458-5149
(612) 681-7768
(912) 681-7782
Mailing address
518 GENTILLY RD, STATESBORO, GA 30458-5149
(612) 681-7768
(912) 681-7782
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP008690
GA
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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