MEDICARE: STEPHANIE KNUTSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist		WI

General Provider Information

NPI Number	:	1043167216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE KNUTSON

Provider Business Mailing Address
First Line	:	1419 RAEDEL RD
Second Line	:
City	:	EAU CLAIRE
State	:	WI
Zip	:	54703-5040
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 VINE ST
Second Line	:
City	:	EAU CLAIRE
State	:	WI
Zip	:	54703-4978
Country	:	US
Telephone Number	:	715-852-4900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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Directions to “ STEPHANIE KNUTSON ” Practice Location

Language	Start Address	Practice Location

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