MEDICARE: VICTORIA HEITZMANN LENHARD AUD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	2018018231	MO

General Provider Information

NPI Number	:	1124511845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA HEITZMANN LENHARD AUD

Provider Business Mailing Address
First Line	:	1000 LAKE SAINT LOUIS BLVD STE 115
Second Line	:
City	:	LAKE ST LOUIS
State	:	MO
Zip	:	63367-2923
Country	:	US
Telephone Number	:	314-394-1911
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 LAKE SAINT LOUIS BLVD STE 115
Second Line	:
City	:	LAKE ST LOUIS
State	:	MO
Zip	:	63367-2923
Country	:	US
Telephone Number	:	314-394-1911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2018
Last Update Date	:	01/27/2026

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