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General NPI Number Information
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NPI Number | 1851033963
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Entity Type | Individual
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Provider Name | MEGAN MAE HEINKE
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Gender | Female
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Dates
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Enumeration Date | 04/09/2022
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Last Update Date | 04/25/2022
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Provider Practice Location Address
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Address Line | 736 E MILITARY AVE
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City | FREMONT
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State | NE
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Zip | 68025-5183
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Country | US
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Telephone | 402-512-1884
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Fax |
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Provider Business Mailing Address
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Address Line | 9061 MEADOW DR
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City | OMAHA
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State | NE
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Zip | 68114-2224
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Country | US
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Telephone | 402-317-8599
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 12934
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License Number State | NE
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