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NPI Code Detail

MEDICARE: MS. STEPHANIE L SPECK M.ED., PCC

MEDICARE: MS. STEPHANIE L SPECK M.ED., PCC
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
1101YP2500XProfessional CounselorE0008312OH

General Provider Information

NPI Number : 1174788723
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEPHANIE L SPECK M.ED., PCC
Provider Business Mailing Address
First Line : 123 22ND ST
Second Line :
City : TOLEDO
State : OH
Zip : 43604-2706
Country : US
Telephone Number : 419-241-6191
Fax Number :
Provider Business Practice Location Address
First Line : 123 22ND ST
Second Line :
City : TOLEDO
State : OH
Zip : 43604-2706
Country : US
Telephone Number : 419-241-6191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2008
Last Update Date : 07/23/2008

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