MEDICARE: JOANN STASIA HUPRICH CCC-SLP

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	SA2937	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417147828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANN STASIA HUPRICH CCC-SLP

Provider Business Mailing Address
First Line	:	PO BOX 741644
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33474-1644
Country	:	US
Telephone Number	:	561-252-5030
Fax Number	:

Provider Business Practice Location Address
First Line	:	5550 SPRING LAKE TER
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3350
Country	:	US
Telephone Number	:	561-252-5030
Fax Number	:	561-732-3397

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

Provider Enumeration Date	:	07/31/2007
Last Update Date	:	07/31/2007

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