Provider Demographics
NPI:1770747354
Name:HEPOKOSKI, JENNY LYN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:LYN
Last Name:HEPOKOSKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5155 E RIVER RD
Mailing Address - Street 2:#403
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55421-1025
Mailing Address - Country:US
Mailing Address - Phone:763-572-2519
Mailing Address - Fax:763-572-2616
Practice Address - Street 1:5155 E RIVER RD
Practice Address - Street 2:#403
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55421-1025
Practice Address - Country:US
Practice Address - Phone:763-572-2519
Practice Address - Fax:763-572-2616
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8380235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist