Healthcare Provider Details

I. General information

NPI: 1235338609
Provider Name (Legal Business Name): HEIDI NICOLE SCHILLING MA CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS HEIDI NICOLE HEINSEN

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11408 ZION RD
BLOOMINGTON MN
55437-3634
US

IV. Provider business mailing address

11408 ZION RD
BLOOMINGTON MN
55437-3634
US

V. Phone/Fax

Practice location:
  • Phone: 612-388-1235
  • Fax:
Mailing address:
  • Phone: 612-388-1235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number8058
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: