Healthcare Provider Details

I. General information

NPI: 1194377721
Provider Name (Legal Business Name): HAILEE JAE WHEMPNER MA CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2019
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E 38TH ST SIOUX FALLS
SIOUX FALLS SD
57105-5898
US

IV. Provider business mailing address

4916 S GRINNELL AVE
SIOUX FALLS SD
57106-7658
US

V. Phone/Fax

Practice location:
  • Phone: 605-773-3678
  • Fax:
Mailing address:
  • Phone: 605-868-0406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number970
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: