Provider Demographics
NPI:1407009871
Name:HEPPNER, MARIE E (MA, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:E
Last Name:HEPPNER
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:E
Other - Last Name:SKUMMY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC/SLP
Mailing Address - Street 1:86 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-3440
Mailing Address - Country:US
Mailing Address - Phone:516-354-2367
Mailing Address - Fax:
Practice Address - Street 1:86 WILLOW ST
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-3440
Practice Address - Country:US
Practice Address - Phone:516-354-2367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009666-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist