Provider Demographics
NPI:1184899882
Name:HEEGEL, MELINDA A (CCC-A)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:A
Last Name:HEEGEL
Suffix:
Gender:F
Credentials:CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5124 S WESTERN AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5047
Mailing Address - Country:US
Mailing Address - Phone:605-275-5545
Mailing Address - Fax:605-275-5546
Practice Address - Street 1:5124 S WESTERN AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5047
Practice Address - Country:US
Practice Address - Phone:605-275-5545
Practice Address - Fax:605-275-5546
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD11237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD11OtherSD BOARD OF HEARING AID DISPENSERS AND AUDIOLOGISTS