Healthcare Provider Details

I. General information

NPI: 1437581345
Provider Name (Legal Business Name): PATRICIA PEICHEL SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2013
Last Update Date: 08/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1772 STEIGER LAKE LN SUITE 100
VICTORIA MN
55386-7723
US

IV. Provider business mailing address

1772 STEIGER LAKE LN SUITE 100
VICTORIA MN
55386-7723
US

V. Phone/Fax

Practice location:
  • Phone: 952-443-9888
  • Fax: 952-443-9804
Mailing address:
  • Phone: 952-443-9888
  • Fax: 952-443-9804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number9162
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: