Most Relevant Information
Provider Data
| NPI Number: | 1003078445 |
| Provider Name: | THOMAS W HEATLEY MS CCC |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | SP 5397 |
Most Important Dates
| Enumeration Date: | 06/26/2008 |
| Last Updated: | 11/01/2010 |
Provider Practice Location
24451 HEALTH CTR DR
LAGUNA HILLS
CA
926523689
Practice Location Phone/Fax
| Phone: | 9498374500 |
| Fax: | 9496990535 |
Provider Mailing Location
24451 HEALTH CTR DR
LAGUNA HILLS
CA
926523689
Provider Mailing Phone/Fax
| Phone: | 9498374500 |
| Fax: | 9496990535 |