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General NPI Number Information
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NPI Number | 1265382279
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Entity Type | Organization
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Legal Business Name | VIVERA SLP LLC
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 2203 MIDWAY BLVD
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City | WAUSAU
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State | WI
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Zip | 54403-6951
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Country | US
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Telephone | 715-255-0261
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Fax |
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Provider Business Mailing Address
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Address Line | 2203 MIDWAY BLVD
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City | WAUSAU
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State | WI
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Zip | 54403-6951
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER/OWNER
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Name | STEPHANIE FAY
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Credential | MS CCC-SLP
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Telephone | 715-581-7833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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