Provider Demographics
NPI:1396962726
Name:HEINO, MONICA
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:HEINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7831 E BUSH LAKE RD
Mailing Address - Street 2:STE 200B
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3164
Mailing Address - Country:US
Mailing Address - Phone:612-223-7992
Mailing Address - Fax:
Practice Address - Street 1:7831 E BUSH LAKE RD
Practice Address - Street 2:STE 200B
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55439-3164
Practice Address - Country:US
Practice Address - Phone:612-564-8476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN17601104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker