Healthcare Provider Details

I. General information

NPI: 1639681091
Provider Name (Legal Business Name): BROOKE ELIZABETH STEINER CFY-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 11/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 N MAIN ST
OREGON WI
53575-1426
US

IV. Provider business mailing address

354 N MAIN ST
OREGON WI
53575-1426
US

V. Phone/Fax

Practice location:
  • Phone: 608-830-5141
  • Fax: 866-290-9061
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number464725798
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4568
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: