Provider Demographics
NPI:1497975627
Name:HEINEMEYER, JANE CLEM (MA, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:CLEM
Last Name:HEINEMEYER
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:MRS
Other - First Name:JANE
Other - Middle Name:MARIE
Other - Last Name:CLEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC/SLP
Mailing Address - Street 1:414 EAST CLARK ST
Mailing Address - Street 2:USD SPEECH & HEARING CENTER
Mailing Address - City:VERMILLION
Mailing Address - State:SD
Mailing Address - Zip Code:57069
Mailing Address - Country:US
Mailing Address - Phone:605-677-5474
Mailing Address - Fax:605-677-5767
Practice Address - Street 1:520 S. 1ST AVE
Practice Address - Street 2:USD SCOTTISH RITE CHILDREN'S CLINIC
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-6902
Practice Address - Country:US
Practice Address - Phone:605-336-7561
Practice Address - Fax:605-330-9820
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD00171116235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist