Provider Demographics
NPI:1962278325
Name:VAN WINKLE, HEIDI RENEE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:RENEE
Last Name:VAN WINKLE
Suffix:
Gender:
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 1:3699 E NOBLES RD
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2040
Mailing Address - Country:US
Mailing Address - Phone:314-324-2582
Mailing Address - Fax:
Practice Address - Street 1:1860 N LINCOLN ST FL 11
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-7300
Practice Address - Country:US
Practice Address - Phone:720-423-2660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0004431235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist