MEDICARE: ERIN STECK

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	22005617A	IN
2	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1356681605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN STECK

Provider Business Mailing Address
First Line	:	12784 N RD.
Second Line	:
City	:	GRANTSBURG
State	:	WI
Zip	:	54840
Country	:	US
Telephone Number	:	414-405-3165
Fax Number	:

Provider Business Practice Location Address
First Line	:	12784 NORTH RD
Second Line	:
City	:	GRANTSBURG
State	:	WI
Zip	:	54840-8121
Country	:	US
Telephone Number	:	414-405-3165
Fax Number	:

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

Provider Enumeration Date	:	02/24/2013
Last Update Date	:	07/21/2022

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Directions to “ ERIN STECK ” Practice Location

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