Provider Demographics
NPI:1598127037
Name:HEIMER, LEANN (MA)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:
Last Name:HEIMER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56283-1722
Mailing Address - Country:US
Mailing Address - Phone:507-430-0261
Mailing Address - Fax:
Practice Address - Street 1:231 E 2ND ST
Practice Address - Street 2:
Practice Address - City:REDWOOD FALLS
Practice Address - State:MN
Practice Address - Zip Code:56283-2617
Practice Address - Country:US
Practice Address - Phone:507-430-0261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional