Healthcare Provider Details

I. General information

NPI: 1760992853
Provider Name (Legal Business Name): MARGARET KNOERZER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7770 BURR ST
SCHERERVILLE IN
46375-3567
US

IV. Provider business mailing address

4881 W 93RD TER
CROWN POINT IN
46307-1679
US

V. Phone/Fax

Practice location:
  • Phone: 219-322-8855
  • Fax:
Mailing address:
  • Phone: 708-227-5147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: