Most Relevant Information
Provider Data
| NPI Number: | 1003208851 |
| Provider Name: | HEATHER ANN BANCROFT M.S. CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 4064 |
Most Important Dates
| Enumeration Date: | 03/02/2015 |
| Last Updated: | 08/29/2023 |
Provider Practice Location
W6415 SONNY DR APT 8
MENASHA
WI
549529038
Practice Location Phone/Fax
| Phone: | 9203654417 |
| Fax: | 9203389121 |
Provider Mailing Location
W6415 SONNY DR APT 8
MENASHA
WI
549529038
Provider Mailing Phone/Fax
| Phone: | 9203654417 |
| Fax: | 9203389121 |