MEDICARE: EMILY BELTER M.S.,CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	3151-154	WI

General Provider Information

NPI Number	:	1013241777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY BELTER M.S.,CCC-SLP

Provider Business Mailing Address
First Line	:	110 S WISCONSIN ST
Second Line	:	STE 8
City	:	PORT WASHINGTON
State	:	WI
Zip	:	53074-2249
Country	:	US
Telephone Number	:	262-689-8031
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 S WISCONSIN ST
Second Line	:	STE 8
City	:	PORT WASHINGTON
State	:	WI
Zip	:	53074-2249
Country	:	US
Telephone Number	:	262-689-8031
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2009
Last Update Date	:	02/20/2019

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