MEDICARE: MRS. STEFANIE BECERRIL M.A., 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	107673	TX
2	235Z00000X	Speech-Language Pathologist	6769	LA

General Provider Information

NPI Number	:	1609121946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEFANIE BECERRIL M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	405 CHATEAU PL
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-4723
Country	:	US
Telephone Number	:	847-445-9511
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 CHATEAU PL
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-4723
Country	:	US
Telephone Number	:	847-445-9511
Fax Number	:

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

Provider Enumeration Date	:	07/23/2012
Last Update Date	:	03/17/2018

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Directions to “ MRS. STEFANIE BECERRIL M.A., CCC-SLP” Practice Location

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