Provider Demographics
NPI:1982152336
Name:HOEMANN, KEENA RENEE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KEENA
Middle Name:RENEE
Last Name:HOEMANN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 S 46TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-2199
Mailing Address - Country:US
Mailing Address - Phone:360-739-7275
Mailing Address - Fax:
Practice Address - Street 1:1145 MT BAKER HWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8769
Practice Address - Country:US
Practice Address - Phone:360-756-1495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60690643235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist