Provider Demographics
NPI:1437561024
Name:HEEPKE, JENNIFER
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:HEEPKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3435
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-0688
Mailing Address - Country:US
Mailing Address - Phone:516-776-2470
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 3435
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-0688
Practice Address - Country:US
Practice Address - Phone:516-776-2470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-30
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst