Provider Demographics
NPI:1043266687
Name:ARNOLDUSSEN, HEATHER (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:ARNOLDUSSEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5371 PARK WAY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2669
Mailing Address - Country:US
Mailing Address - Phone:608-225-2531
Mailing Address - Fax:
Practice Address - Street 1:14 ELLIS POTTER CT
Practice Address - Street 2:SUITE 200
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2478
Practice Address - Country:US
Practice Address - Phone:608-204-6242
Practice Address - Fax:608-204-6249
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1272-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist