Healthcare Provider Details

I. General information

NPI: 1609703768
Provider Name (Legal Business Name): HEIDI PLIWKO M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 POLK ST
STEVENS POINT WI
54481-5875
US

IV. Provider business mailing address

2601 RAINBOW DR
PLOVER WI
54467-2549
US

V. Phone/Fax

Practice location:
  • Phone: 715-345-5454
  • Fax:
Mailing address:
  • Phone: 715-345-5454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1001239326
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: