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Individual

HEIDI DURHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
3750 E COUNTRY FIELD CIR STE B, WASILLA, AK 99654-6659
(907) 373-1410
(907) 373-1411
Mailing address
3750 E COUNTRY FIELD CIR STE B, WASILLA, AK 99654-6659
(907) 373-1410
(907) 373-1411

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
17785
TX
235Z00000X
Speech-Language Pathologist
Primary
194636
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
173505
AK
Enumeration date
08/08/2011
Last updated
08/04/2022
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