Provider Demographics
NPI:1841780285
Name:HENKEMEYER, SYDNEE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SYDNEE
Middle Name:
Last Name:HENKEMEYER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:SYDNEE
Other - Middle Name:
Other - Last Name:BRAUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7780 PRIMROSE GRN
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:CO
Mailing Address - Zip Code:80530-7049
Mailing Address - Country:US
Mailing Address - Phone:920-277-9816
Mailing Address - Fax:
Practice Address - Street 1:7780 PRIMROSE GRN
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:CO
Practice Address - Zip Code:80530-7049
Practice Address - Country:US
Practice Address - Phone:920-277-9816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14412661235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist