Healthcare Provider Details

I. General information

NPI: 1891810693
Provider Name (Legal Business Name): KARA STIMAC M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 10/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 CYNTHIA CT
SCHERERVILLE IN
46375-3016
US

IV. Provider business mailing address

1514 CYNTHIA CT
SCHERERVILLE IN
46375-3016
US

V. Phone/Fax

Practice location:
  • Phone: 219-677-0756
  • Fax: 219-322-6429
Mailing address:
  • Phone: 219-677-0756
  • Fax: 219-322-6429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22004660A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: