Provider Demographics
NPI:1639850456
Name:DEJOHN, HEATHER R
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:R
Last Name:DEJOHN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:RENAE
Other - Last Name:GOHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3612 CUMING ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-1900
Mailing Address - Country:US
Mailing Address - Phone:402-898-6067
Mailing Address - Fax:402-898-6063
Practice Address - Street 1:3612 CUMING ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-1900
Practice Address - Country:US
Practice Address - Phone:402-898-6067
Practice Address - Fax:402-898-6063
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker