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NPI Code Detail

MEDICARE: ERICA HEITKAMP

MEDICARE:   ERICA  HEITKAMP
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
1235Z00000XSpeech-Language Pathologist
2235Z00000XSpeech-Language PathologistSP.11557OH

General Provider Information

NPI Number : 1609346592
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA HEITKAMP
Provider Business Mailing Address
First Line : 2096 COUNTY ROAD 24 S
Second Line :
City : DE GRAFF
State : OH
Zip : 43318-9406
Country : US
Telephone Number : 937-585-5981
Fax Number :
Provider Business Practice Location Address
First Line : 2096 COUNTY ROAD 24 S
Second Line :
City : DE GRAFF
State : OH
Zip : 43318-9406
Country : US
Telephone Number : 937-585-5981
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2018
Last Update Date : 12/04/2018

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Directions to “ ERICA HEITKAMP ” Practice Location

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