MEDICARE: MRS. HEIDI KROLIKOWSKI M.S.

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1891152427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEIDI KROLIKOWSKI M.S.

Provider Business Mailing Address
First Line	:	800 N 8TH ST
Second Line	:	POB 628
City	:	LOUP CITY
State	:	NE
Zip	:	68853-8020
Country	:	US
Telephone Number	:	308-745-0603
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 N 8TH ST
Second Line	:	POB 628
City	:	LOUP CITY
State	:	NE
Zip	:	68853-8020
Country	:	US
Telephone Number	:	308-745-0603
Fax Number	:

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

Provider Enumeration Date	:	01/27/2016
Last Update Date	:	01/28/2016

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