Healthcare Provider Details

I. General information

NPI: 1194043729
Provider Name (Legal Business Name): HEIDI MARIE ASMUS MS,CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2010
Last Update Date: 09/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 1ST ST
MORRIS MN
56267-1408
US

IV. Provider business mailing address

8 RIVERSIDE RD
MORRIS MN
56267-9476
US

V. Phone/Fax

Practice location:
  • Phone: 320-589-1313
  • Fax:
Mailing address:
  • Phone: 320-585-6634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number8014
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: