Provider Demographics
NPI:1710068424
Name:HILL, HEIDI J (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:J
Last Name:HILL
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10909 EXCELSIOR BLVD
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-3420
Mailing Address - Country:US
Mailing Address - Phone:952-746-0232
Mailing Address - Fax:952-746-2521
Practice Address - Street 1:10909 EXCELSIOR BLVD
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-3420
Practice Address - Country:US
Practice Address - Phone:952-746-0232
Practice Address - Fax:952-746-2521
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6435231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3606779100Medicaid