| Doctor Name: | DR. MYRA JEAN HECKENLAIBLE-GOTTO |
| NPI Number: | 1801955315 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.P. |
| License Number: | LP4507 |
| Business Practice Address: | 1450 Highway 60 71 N Windom, MN - 561012025 |
| Business Phone Number: | 6053347713 |
| Business Fax Number: | |
| Mailing Address: | 625 S Minnesota Ave, Suite 201 SIOUX FALLS |
| State: | SD |
| Postal Code: | 571044871 |
| Phone Number: | 6053347713 |
| Fax Number: | |
| NPI Enumeration Date: | 12/08/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | LP4507 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |