1235338609 NPI number — MRS. HEIDI NICOLE SCHILLING MA CCC SLP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235338609 NPI number — MRS. HEIDI NICOLE SCHILLING MA CCC SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHILLING
Provider First Name:
HEIDI
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA CCC SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HEINSEN
Provider Other First Name:
HEIDI
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235338609
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1800 2ND STREET NE
Provider Second Line Business Mailing Address:
A CHANCE TO GROW INC
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55418
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-789-1236
Provider Business Mailing Address Fax Number:
612-706-5555

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 2ND STREET NE
Provider Second Line Business Practice Location Address:
A CHANCE TO GROW INC
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-789-1236
Provider Business Practice Location Address Fax Number:
612-706-5555
Provider Enumeration Date:
07/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  8058 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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