National Provider Identifier

Heather Kaczor, CCC-SLP

Heather Kaczor, CCC-SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Forestville, NY and a listed phone number of (716) 965-2742.

NPI 1457669350Forestville, NYSpeech-Language Pathologist

Profile Overview

NPI
1457669350
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
September 14, 2010
Last Updated
September 07, 2017

Practice Location

  • 12 Water St
  • Forestville, NY 14062-9608

Phone: (716) 965-2742

Mailing Address

  • 10567 Old Lake Shore RD
  • Irving, NY 14081-9554

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1457669350
Entity Type
Individual
Last Name
Kaczor
First Name
Heather
Name Prefix
Mrs.
Credential
CCC-SLP
Provider Other Last Name
Van Slycke
Provider Other First Name
Heather
Provider Other Last Name Type Code
1
Mailing Street Address
10567 Old Lake Shore RD
Mailing City
Irving
Mailing State
NY
Mailing ZIP Code
14081-9554
Mailing Country
US
Mailing Phone
(716) 207-1579
Practice Street Address
12 Water St
Practice City
Forestville
Practice State
NY
Practice ZIP Code
14062-9608
Practice Country
US
Practice Phone
(716) 965-2742
Practice Fax
(716) 965-2786
Enumeration Date
September 14, 2010
Last Updated
September 07, 2017
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)