Provider Demographics
NPI:1215100292
Name:KAMMERER, HEIDI CHRISTINE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:CHRISTINE
Last Name:KAMMERER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9059 PRIVATE ROAD 6421
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-6693
Mailing Address - Country:US
Mailing Address - Phone:417-293-6754
Mailing Address - Fax:
Practice Address - Street 1:1521 S US HIGHWAY 63
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-6091
Practice Address - Country:US
Practice Address - Phone:417-293-6754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007033582235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist