Provider Demographics
NPI:1811043300
Name:SESMA, HEATHER WHITNEY (PHD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:WHITNEY
Last Name:SESMA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LYNN
Other - Last Name:WHITNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MAYO MAIL CODE 486
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:612-625-7466
Mailing Address - Fax:612-624-7681
Practice Address - Street 1:516 DELAWARE ST SE
Practice Address - Street 2:12-169 PHILLIPS WANGENSTEEN BUILDING
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0356
Practice Address - Country:US
Practice Address - Phone:612-625-7466
Practice Address - Fax:612-624-7681
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4870103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist