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HEATHER A BOURGAULT SLP
>> Speech-Language Pathologist >> Speech, Language and Hearing Service ProvidersRegistrant NPI Number: 1225333685
Individual Registrant: HEATHER A BOURGAULT SLP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
900 MAIN ST OAKVILLE, CT 06779-1999 US
Tel: 860-945-3012 Fax: 860-945-9854
Tel: 860-945-3012 Fax: 860-945-9854
Contact information for business:
900 MAIN ST OAKVILLE, CT 06779-1999 US
Tel: 860-945-3012 Fax: 860-945-9854
Tel: 860-945-3012 Fax: 860-945-9854
Registration Information:
NPI: 1225333685
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 235Z00000X | Speech, Language and Hearing Service Providers Speech-Language Pathologist | CT | 4184 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
